MS. ERIN FENNERN – Colon & Rectal Surgery Physician, NPI 1295175008

MS. ERIN FENNERN is a healthcare provider. based in Portland, Oregon. specializing in COLORECTAL SURGERY (PROCTOLOGY). They hold a License No. M-17325 (ID). The NPI Number for MS. ERIN FENNERN is 1295175008

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
MS. ERIN FENNERN
NPI
1295175008
Phone
(347) 525-3696
Address
933 SE 15TH AVE
Enumeration Date
26 June 2013
Last Update Date
29 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2083812222
Graduation Year
2015 (11 years ago)
PAC ID
6901260645
Group Practice PAC ID
4981878402
Professional Enrollment ID
I20230913002020
Address ID
ID837126269BO100XXSTXX406
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:12State licenses:1Digital endpointsOther names

39 COLORECTAL SURGERY (PROCTOLOGY) in OR

Provider Addresses for MS. ERIN FENNERN

  • 933 SE 15TH AVE

    PORTLAND, OR 972142609

    Phone: (347) 525-3696

    Type: Mailing

  • 3181 SW SAM JACKSON PARK RD

    OHSU

    PORTLAND, OR 972393011

    Phone: (503) 494-8220

    Type: Location

  • 3181 SW Sam Jackson Park Rd

    OHSU

    Portland, OR 972393011

    Phone: (503) 494-8220

    Type: Location

  • 190 E BANNOCK ST

    BOISE, ID 837126241

    Phone:

    Type: Mailing

  • 100 E IDAHO ST STE 316

    BOISE, ID 837126269

    Phone: (208) 381-9350

    Fax: (208) 381-9351

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 14 Open Payments records for all available years, with a total value of $4,337.

Total Amount is formed as General ($4,337) + Research ($0) + Ownership ($0) = $4,337.

Last reported payment date: 2024-05-21 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($4,212).

Total Amount

$4,337

General + Research + Ownership

Payments

14

Total payment records

General Amount

$4,337

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-21

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2023-09-13

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
I20230913002020IColorectal Surgery (Proctology)IDTBD

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 97214)

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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: 4981878402View full group profile
NameSpecialtyState
Family PracticeME
Internal MedicineID
Family PracticeID
-TX
-OR
Hand SurgeryID
-ID
Nurse PractitionerID
Physician AssistantID
General SurgeryID

Reviews

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Frequently asked questions

What NPI should I save for MS. ERIN FENNERN?
Save NPI 1295175008 if you need a stable reference for MS. ERIN FENNERN.
Is MS. ERIN FENNERN's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does MS. ERIN FENNERN treat or focus on?
Patients typically see MS. ERIN FENNERN under the specialty Colon & Rectal Surgery Physician. Clinical services aligned with this taxonomy classification.
Where is MS. ERIN FENNERN's primary listing?
We display Portland, Oregon because that is what the record indicates for MS. ERIN FENNERN.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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