DR. JONATHAN JELMINI (DDS, MD) – Dentist, NPI 1477000164
Dentist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
18 ORAL SURGERY in OR
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Provider Addresses for DR. JONATHAN JELMINI (DDS, MD)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 972393011
Phone: (503) 494-8916
Fax: (503) 494-6783
Type: Mailing
Southwest Oak Street, Chinatown, Old Town, Portland, Metro, Multnomah County, Oregon, 97204, United States
PORTLAND, OR 972235811
Phone:
Type: Mailing
1500 S MAIN ST
FORT WORTH, TX 761044917
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 24 Open Payments records for all available years, with a total value of $1,485.
Total Amount is formed as General ($1,485) + Research ($0) + Ownership ($0) = $1,485.
Last reported payment date: 2024-10-17 • Largest payer in this snapshot: KLS-Martin L.P. ($532).
Total Amount
$1,485
General + Research + Ownership
Payments
24
Total payment records
General Amount
$1,485
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| KLS-Martin L.P. | $532 |
| Smith+Nephew, Inc. | $361 |
| Stryker Corporation | $214 |
| DePuy Synthes Sales Inc. | $117 |
| AXOGEN | $107 |
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: 2025-03-26
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220705002936 | I | Oral Surgery | TX | TBD |
| I20250326002387 | I | Oral 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 51 | 33 | $0 |
Insurance plans in this area (ZIP 97239)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| Diagnostic Radiology | TN | |
| - | OR | |
| Nurse Practitioner | OR | |
| - | OR | |
| - | OR | |
| General Surgery, Thoracic Surgery | WA | |
| - | OR | |
| - | OR | |
| - | WA |
Reviews
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