DR. PAUL U YUTAN (M.D.) – Internal Medicine Physician, NPI 1114963196

DR. PAUL U YUTAN (M.D.) is a healthcare provider. based in Portland, Oregon. specializing in INTERNAL MEDICINE. They hold the professional credentials M.D.. They hold a License No. MD24270 (OR). The NPI Number for DR. PAUL U YUTAN (M.D.) is 1114963196

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
DR. PAUL U YUTAN (M.D.)
NPI
1114963196
Phone
(503) 215-0750
Address
4400 NE Halsey St Bldg 24th
Enumeration Date
20 June 2006
Last Update Date
4 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5032150750
Graduation Year
1997 (29 years ago)
PAC ID
2365579737
Group Practice PAC ID
0648183608
Professional Enrollment ID
I20100416000697
Address ID
OR972134720PO6350XSTXX400
Telehealth
Yes

Contacts

Secure Messaging
pyutan117835@oc.providencedirect.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

2,475 INTERNAL MEDICINE in OR

Provider Addresses for DR. PAUL U YUTAN (M.D.)

  • 4400 NE Halsey St Bldg 24th

    Portland, OR 972131545

    Phone: (503) 215-0750

    Fax: (971) 282-0112

    Type: Location

  • Andrew C. DeWeese, 4531, Southeast Belmont Street, Hawthorne, Sunnyside, Portland, Metro, Multnomah County, Oregon, 97215, United States

    SUITE 100

    PORTLAND, OR 972151675

    Phone:

    Type: Mailing

  • Providence Elderplace Glendoveer, 13007, Northeast Glisan Street, Hazelwood, Portland, Metro, Multnomah County, Oregon, 97230, United States

    PORTLAND, OR 972302545

    Phone: (503) 215-3859

    Type: Location

  • 14110 GABRIELLE CT

    LAKE OSWEGO, OR 970355759

    Phone: (503) 314-7889

    Type: Mailing

  • 14535 WESTLAKE DR STE B

    LAKE OSWEGO, OR 970357775

    Phone: (503) 479-5608

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2010-04-16

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100416000697IInternal MedicineORTBD

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.

Verify on CMS Revalidation Lookup Tool

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 97213)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648183608View full group profile
NameSpecialtyState
Internal MedicineOR
Physician AssistantOR
-OR
N E U R O L O G YOR
Nurse PractitionerOR
Infectious Disease, Internal MedicineOR
Thoracic SurgeryOR
Nurse PractitionerOR
Physician AssistantWA
Clinical PsychologistOR

Reviews

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Frequently asked questions

Does DR. PAUL U YUTAN (M.D.) have a public NPI I can cite?
Public records show DR. PAUL U YUTAN (M.D.) under NPI 1114963196.
Should I treat DR. PAUL U YUTAN (M.D.) as an active provider?
Patients and plans typically see DR. PAUL U YUTAN (M.D.) as active in the national extract.
What services align with DR. PAUL U YUTAN (M.D.)'s listing?
DR. PAUL U YUTAN (M.D.)'s public classification highlights Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. PAUL U YUTAN (M.D.)?
DR. PAUL U YUTAN (M.D.) is associated with Portland, Oregon in the same public data insurers reference.
Can I export DR. PAUL U YUTAN (M.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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