MARY ELIZABETH GISWOLD (MD) – Surgery Physician, NPI 1164509733

MARY ELIZABETH GISWOLD (MD) is a healthcare provider. based in Clackamas, Oregon. specializing in GENERAL SURGERY. They hold the professional credentials MD. They hold a License No. MD23643 (OR). The NPI Number for MARY ELIZABETH GISWOLD (MD) is 1164509733

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
MARY ELIZABETH GISWOLD (MD)
NPI
1164509733
Phone
(503) 571-3099
Address
10100 SE SUNNYSIDE RD
Enumeration Date
1 November 2006
Last Update Date
4 February 2022

Doctor Profile

Medical School Name
UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Secondary Phone
8008132000
Graduation Year
1998 (28 years ago)
PAC ID
0143260463
Group Practice PAC ID
5799688230
Professional Enrollment ID
I20071211000713
Address ID
OR970158970CL10180RDXX400

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

530 GENERAL SURGERY in OR

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Provider Addresses for MARY ELIZABETH GISWOLD (MD)

  • 10100, Southeast Sunnyside Road, Harmony, Oatfield, Metro, Clackamas County, Oregon, 97015, United States

    CLACKAMAS, OR 970158970

    Phone: (503) 571-3099

    Type: Location

  • 4030, Northeast Stanton Street, Beaumont-Wilshire, Portland, Multnomah County, Oregon, 97212, United States

    PORTLAND, OR 972122957

    Phone: (503) 281-4213

    Type: Mailing

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: 2010-01-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20071211000713IGeneral SurgeryORTBD
I20100115000065IGeneral SurgeryWATBD

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 97015)

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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: 5799688230View full group profile
NameSpecialtyState
U R O L O G YTX
Emergency MedicineOR
D E R M A T O L O G YAZ
Nurse PractitionerOR
Diagnostic RadiologyOR
D E R M A T O L O G YWA
-OR
-CA
General SurgeryCA
-OR

Reviews

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Frequently asked questions

How is MARY ELIZABETH GISWOLD (MD) identified in CMS data?
CMS-hosted NPPES data lists MARY ELIZABETH GISWOLD (MD) with NPI 1164509733.
Is MARY ELIZABETH GISWOLD (MD) still practicing?
MARY ELIZABETH GISWOLD (MD) is currently listed as active in the public NPI registry.
What taxonomy line describes MARY ELIZABETH GISWOLD (MD)?
For research purposes, treat MARY ELIZABETH GISWOLD (MD) as Surgery Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is MARY ELIZABETH GISWOLD (MD) based?
MARY ELIZABETH GISWOLD (MD) is tied to Clackamas, Oregon in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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