NPIMap

Individual provider Active NPI

Sergio Manuel Crespo, M.D.

  • Gastroenterology Physician
  • Portland, OR
National Provider Identifier
1902099484
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD154326 Issued in OR
Practice address
9701 SW Barnes Rd
Suite 300
Portland, OR 97225-6772
Phone
(503) 297-8081
Fax
(503) 292-6601
NPI assigned
Aug 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME101345 FL
Gastroenterology Physician 207RG0100X MD154326 OR Primary
Internal Medicine Physician 207R00000X MT186045 PA

Addresses

Primary practice location

9701 SW Barnes Rd
Suite 300
Portland, OR 97225-6772

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other identifiers 2

IdentifierTypeStateIssuer
500636652MedicaidOR
2028702MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_gastro_west_front_desk_pool12223293@oc.providencedirect.org The Oregon Clinic PC

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
I20110922000187 OR Practitioner - Gastroenterology 1850467564 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Oregon Health Sciences University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

9701 SW Barnes
Suite 300
Portland, OR 97225-6689
Phone (503) 297-8081

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Adventist Health Tillamook Hospital, Tillamook, OR, CCN 381317
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Providence Seaside Hospital Hospital, Seaside, OR, CCN 381303

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy34
Upper gastrointestinal (GI) endoscopy for acid reflux50

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT186045PAMDInternal Medicine Physician
ME101345FLMDGastroenterology Physician
MD154326ORMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic, PC CurrentSince Oct 1, 2015 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
The Oregon Clinic PC Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Gastroenterology Associates, P.C. Past Accepting new patients

Locations

9701 SW Barnes Rd
Ste 300
Portland, OR 97225
Phone (503) 297-8081

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

10000 SE Main St
Ste 112
Portland, OR 97216
Phone (503) 255-3054

847 NE 19th Ave
Ste 300
Portland, OR 97232

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

Interoperability endpoints

  • Direct secure messaging: screspo552520@oc.providencedirect.org

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1902099484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 SW BARNES RD",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256772",
            "telephone_number": "503-297-8081",
            "fax_number": "503-292-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESPO",
        "first_name": "SERGIO",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME101345",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "MD154326",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT186045",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500636652",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2028702",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_gastro_west_front_desk_pool12223293@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "9701 SW Barnes Rd",
            "address_2": "Suite 300",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.