DR. PEDRO ACFALLE JR. MANIBUSAN (D.O.) – Gastroenterology Physician, NPI 1073799722
Gastroenterology Physician
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Profile Insights
NPPES metrics only — not quality of care.
252 GASTROENTEROLOGY in OR
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Provider Addresses for DR. PEDRO ACFALLE JR. MANIBUSAN (D.O.)
Richard T. Jones Hall, 3181, Southwest Sam Jackson Park Road, Marquam Hill, Homestead, Portland, Metro, Multnomah County, Oregon, 97239, United States
PORTLAND, OR 972393011
Phone: (503) 494-4373
Fax: (503) 494-7556
Type: Mailing
1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER, HI 968595001
Phone: (808) 433-5055
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $740.
Total Amount is formed as General ($740) + Research ($0) + Ownership ($0) = $740.
Last reported payment date: 2024-08-20 • Largest payer in this snapshot: Boston Scientific Corporation ($387).
Total Amount
$740
General + Research + Ownership
Payments
10
Total payment records
General Amount
$740
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $387 |
| ABBVIE INC. | $352 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-04-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220429000710 | I | Gastroenterology | HI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97239)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H E M A T O L O G Y/ O N C O L O G Y | WA | |
| Emergency Medicine | CA | |
| Pulmonary Disease | FL | |
| P S Y C H I A T R Y | WA | |
| Emergency Medicine | HI | |
| Nurse Practitioner | NC | |
| Internal Medicine, Critical Care (Intensivists) | HI | |
| - | HI | |
| Internal Medicine, Pulmonary Disease | HI | |
| Orthopedic Surgery | HI |
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