Individual provider Active NPI

Stefanie Peterson Rogers, MD

  • Neonatal-Perinatal Medicine Physician
  • Portland, OR
National Provider Identifier
1790923746
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
MD28951 Issued in OR
Practice address
501 N Graham St Ste 265
Portland, OR 97227-2000
Phone
(503) 326-2447
Fax
(503) 280-1290
NPI assigned
Jan 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X MD28951 OR Primary

Addresses

Primary practice location

501 N Graham St Ste 265
Portland, OR 97227-2000

Mailing address

501 N Graham St Ste 265
Portland, OR 97227-2000
Phone (503) 326-2447

Other names 1

  • Miss Stefanie Lynn Peterson Former name

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
I20111219000332 OR Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8123293248

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Past Accepting new patients
Northwest Newborn Specialists PC Neonatal-Perinatal Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1790923746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 265",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272000",
            "telephone_number": "503-326-2447",
            "fax_number": "503-280-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 265",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272000",
            "telephone_number": "503-326-2447",
            "fax_number": "503-280-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "STEFANIE",
        "middle_name": "PETERSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OR",
            "license": "MD28951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "PETERSON",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.