Randolph K Cribbs, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD168029 Issued in OR

Practice address

9290 SE Sunnybrook Blvd Ste 220
Clackamas, OR 97015

Phone

(503) 215-2890

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Pennsylvania State University College of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Uptown Providers PCGroup PAC ID 4284891243, 43 clinicians

Compass Pain Clinic Oregon PCGroup PAC ID 4082140413, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rcribbs481613@oc.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Compass Pain Clinic Oregon PC

  • Pain Medicine Physician
  • Portland, OR
  • NPI 1225852007

  OR

  Medicare reassignment Care Compare group NPD Authorized official
• Uptown Providers PC

  • Urgent Care Clinic/Center
  • Tigard, OR
  • NPI 1346903531

  OR

  Medicare reassignment Care Compare group
• Uptown Providers PC

  • Urgent Care Clinic/Center
  • Vancouver, WA
  • NPI 1255102034
  Care Compare group
• Compass Pain Clinic Oregon PC

  • Interventional Pain Medicine Physician
  • Portland, OR
  • NPI 1235953654
  NPD
• Uptown Providers PC

  • Urgent Care Clinic/Center
  • Oregon City, OR
  • NPI 1770147357
  NPD
• Uptown Providers PC

  • Urgent Care Clinic/Center
  • Vancouver, WA
  • NPI 1912702465
  NPD
• Salt Lake Wound Care and Hyperbaric

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Salt Lake City, UT
  • NPI 1538187455
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1770675563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9290 SE SUNNYBROOK BLVD STE 220",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97015",
            "telephone_number": "503-215-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIBBS",
        "first_name": "RANDOLPH",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD168029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500679432",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcribbs481613@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9290 SE Sunnybrook Blvd Ste 120",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970156802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcribbs481613@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9290 SE Sunnybrook Blvd Ste 220",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Lee Crawford, DPT
• Kelsey Lynn Crawford, MA
• Matthew Kirkland Creech, DO
• Dolores Creede, RRT, RPFT
• Sonja Creel, MPT
• Gillian Cross
• Crossing Bridges Counseling Center
• Zachary Croy, DPM
• Jill Crum, DO
• Heather Bufford Crummett, M.D.

• All providers in Clackamas, OR
• Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.