NPIMap

Individual provider Active NPI

Nicholas Phillips, MD

  • Sports Medicine (Emergency Medicine) Physician
  • Corvallis, OR
National Provider Identifier
1770803892
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
License
MD169780 Issued in OR
Practice address
845 SW 30TH St
Corvallis, OR 97331-8629
Phone
(541) 768-7700
NPI assigned
Jun 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD169780 OR
Sports Medicine (Emergency Medicine) Physician 207PS0010X MD169780 OR Primary

Addresses

Primary practice location

845 SW 30TH St
Corvallis, OR 97331-8629

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nphillips123248@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150108000265 OR Practitioner - Sports MedicinePractitioner - Emergency Medicine 8729233630 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Emergency Medicine
Education
West Virginia University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Good Samaritan Hospital CorvallisGroup PAC ID 1557270725, 372 clinicians

Practice addresses (Care Compare)

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

845 SW 30TH St
Corvallis, OR 97331-8629
Phone (541) 768-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
85.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

Merit-based Incentive Payment System (MIPS)

Final score
96.77 of 100Reported as group
Quality
88.09
Promoting interoperability
100
Improvement activities
40
Cost
84.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD169780ORMDSports Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Valley Healthcare Inc Current Accepting new patients
Samaritan North Lincoln Hospital Current Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Nov 1, 2014 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Nov 1, 2014 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Nov 1, 2014 Accepting new patients

Locations

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

845 SW 30th St
Corvallis, OR 97331
Phone (541) 768-7700

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

Interoperability endpoints

  • Direct secure messaging: nphillips123248@samhealth.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 66

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1770803892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 SW 30TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318629",
            "telephone_number": "541-768-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD169780",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "OR",
            "license": "MD169780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nphillips123248@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "845 SW 30th St",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973318629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.