Individual provider Active NPI

Sarah Rachel Oller, M.D.

  • Pediatrics Physician
  • Tigard, OR
National Provider Identifier
1982619565
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD26774 Issued in OR
Practice address
12442 SW Scholls Ferry Rd Ste 205
Tigard, OR 97223-0804
Phone
(503) 216-9140
Fax
(503) 216-9145
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

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 MD26774 OR Primary

Addresses

Primary practice location

12442 SW Scholls Ferry Rd Ste 205
Tigard, OR 97223-0804

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other identifiers 2

IdentifierTypeStateIssuer
R176091OtherORPTAN
005964MedicaidOR

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
I20121103000001 OR Practitioner - Pediatric Medicine 0941451769 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD26774ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 22, 2014 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 22, 2014 Accepting new patients
Providence Health & Services - Oregon Pediatrics Past Accepting new patients

Locations

9135 SW Barnes Rd
Ste 761
Portland, OR 97225
Phone (503) 216-2602

12442 SW Scholls Ferry Rd
Ste 205
Tigard, OR 97223
Phone (503) 216-9140

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1982619565",
    "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": "12442 SW SCHOLLS FERRY RD STE 205",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972230804",
            "telephone_number": "503-216-9140",
            "fax_number": "503-216-9145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLLER",
        "first_name": "SARAH",
        "middle_name": "RACHEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD26774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "R176091",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005964",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.