Individual provider Active NPI

Elia R. Cole, DO, MPH

  • Student in an Organized Health Care Education/Training Program
  • Santa Rosa, CA
National Provider Identifier
1881198745
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
401 Bicentennial Way Ste 110
Santa Rosa, CA 95403-2149
Phone
(707) 393-4577
NPI assigned
Mar 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR0067739 CO
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

401 Bicentennial Way Ste 110
Santa Rosa, CA 95403-2149

Mailing address

401 Bicentennial Way Ste 110
Santa Rosa, CA 95403-2149

Other practice location 1

10350 E Dakota Ave
Denver, CO 80247-1314
Phone (303) 338-4545

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220404002353 WA Practitioner - Family Practice 4880005552 Reassigns benefits to 1 organization
I20220404002490 OR Practitioner - Family Practice 4880005552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3175 NE Aloclek Dr
Hillsboro, OR 97124-7135
Phone (800) 813-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR0067739COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Feb 28, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Feb 28, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Feb 28, 2022 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

3175 NE Aloclek Dr
Hillsboro, OR 97124
Phone (503) 240-6148

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 3

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": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1881198745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BICENTENNIAL WAY STE 110",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BICENTENNIAL WAY STE 110",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032149",
            "telephone_number": "707-393-4577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10350 E Dakota Ave",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802471314",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLE",
        "first_name": "ELIA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DO, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR0067739",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10350 E Dakota Ave",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802471314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.