Christelle Serra-Van Brunt, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO197534 Issued in OR

Practice address

10330 SE 32ND Ave
Ste 205
Milwaukie, OR 97222-6587

Phone

(503) 513-8950

NPI assigned

Mar 22, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Family Practice

Education

Western University of Health Sciences College of Dental Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services OregonGroup PAC ID 5294623245, 166 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Medford Medical Center Hospital, Medford, OR, CCN 380075

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Providence Health & Services Oregon

  • Family Medicine Physician
  • Medford, OR
  • NPI 1568547503
  Medicare reassignment Care Compare group NPD
• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Medicare reassignment
• Providence Health & Services - Oregon

  • Vascular Surgery Physician
  • Medford, OR
  • NPI 1750460283
  NPD
• Providence Health & Services - Oregon

  • Clinic/Center
  • Phoenix, OR
  • NPI 1992882500
  NPD
• Providence Health & Services - Oregon

  • Internal Medicine Physician
  • Central Point, OR
  • NPI 1609951649
  NPD (past)

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

• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1689755670
  Care Compare affiliation

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

{
    "created_epoch": "1426982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1922492586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 SE 32ND AVE",
            "address_2": "STE 205",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226587",
            "telephone_number": "503-513-8950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Bower Dr",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975013689",
            "country_code": "US",
            "telephone_number": "541-734-3430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERRA-VAN BRUNT",
        "first_name": "CHRISTELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-22",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO197534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500750480",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cserravanbrunt552333@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "70 Bower Dr",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975013689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kayle Faye Seitz, LAC.
• Tina Sellers, LCSW
• Patrick Merle Sellin, M.A., LPC INTERN
• Randall S Seltmann
• Jenjee T Sengkhammee, PHD
• Sujata Setya, PHYSICAL THERAPIST
• Karen Sewell
• Nicole Shaffer, COTA
• Timothy Patrick Shannon, D.M.D.
• Peter Shapoval

• Family Medicine Physician in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.