Sophia Alexandria Rezayee, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1015 NW 22ND Ave
Portland, OR 97210-3025

Phone

(503) 413-7711

NPI assigned

Apr 8, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sophia Rezayee Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1992558126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15890 SE MISTY DR # C209",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970864355",
            "telephone_number": "503-867-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 NW 22ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103025",
            "telephone_number": "503-413-7711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917661854",
            "country_code": "US",
            "telephone_number": "909-469-5589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZAYEE",
        "first_name": "SOPHIA",
        "middle_name": "ALEXANDRIA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOPHIA",
            "last_name": "REZAYEE",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Olivia Brooks Reynoldson, LAC, DAOM
• Chelsea Reynosa
• Carlos Reynoso
• Giselle Reynoso
• Shiva Rezaei
• John Rezende-Shalom
• Thomas Edwin Rezendes
• Leah Reznick, MD
• Jerry Rhea II
• Fredrick N Rhead, D.C.

• Student in an Organized Health Care Education/Training Program in Portland, OR
• Providers in Portland, OR by specialty
• Student in an Organized Health Care Education/Training Program in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.