DR. ALEXANDER DEMETRE NICOLOFF (M.D.) – Vascular Surgery Physician, NPI 1386610277
Vascular Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. ALEXANDER DEMETRE NICOLOFF (M.D.)
Legacy Emanuel Medical Center, 501, North Graham Street, Albina, Eliot, Portland, Multnomah County, Oregon, 97227, United States
SUITE 415
PORTLAND, OR 972271654
Phone: (503) 413-3580
Fax: (503) 413-3578
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $183.
Total Amount is formed as General ($183) + Research ($0) + Ownership ($0) = $183.
Last reported payment date: 2023-04-05 • Largest payer in this snapshot: Boston Scientific Corporation ($183).
Total Amount
$183
General + Research + Ownership
Payments
2
Total payment records
General Amount
$183
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $183 |
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: 2004-07-20
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 |
|---|---|---|---|---|
| I20040720001010 | I | Vascular Surgery | OR | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 93971 | Ultrasound study of one arm or leg veins with compression and maneuvers | 70 | 59 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 51 | 40 | $0 |
| 36471 | Injection of chemical agent into multiple incompetent veins of leg | 40 | 24 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 24 | 24 | $0 |
| 36475 | Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance | 22 | 15 | $0 |
Insurance plans in this area (ZIP 97227)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | OR | |
| General Surgery | OR | |
| Physician Assistant | OR | |
| Nurse Practitioner | OR | |
| General Surgery | OR | |
| Nurse Practitioner | OR | |
| Physician Assistant | OR | |
| General Surgery | WA | |
| General Surgery | OR | |
| Physician Assistant | OR |
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