Individual provider Active NPI

Laura Michelle Dart, M.D.

  • Pediatrics Physician
  • Portland, OR
National Provider Identifier
1780079350
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD187643 Issued in OR
Practice address
2800 N Vancouver Ave Ste 165
Portland, OR 97227-1644
Phone
(503) 413-2902
NPI assigned
Apr 1, 2015
Last updated
Jan 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD187643 OR Primary

Addresses

Primary practice location

2800 N Vancouver Ave Ste 165
Portland, OR 97227-1644

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8211

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190321001809 OR Practitioner - Pediatric Medicine 6507106994 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD187643ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center CurrentSince Dec 23, 2018 Accepting new patients
Legacy Emanuel Hospital & Health Center Pediatrics CurrentSince Dec 23, 2018 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Olson Pediatric Clinic, LLC Past Accepting new patients

Locations

2800 N Vancouver Ave
Ste 165
Portland, OR 97227
Phone (503) 413-2902

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

Interoperability endpoints

  • Direct secure messaging: lwood120983@direct.lhs.org

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1780079350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N VANCOUVER AVE STE 165",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271644",
            "telephone_number": "503-413-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DART",
        "first_name": "LAURA",
        "middle_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD187643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.