KIMBERLY SUE ELTZROTH (M.D.) – Obstetrics & Gynecology Physician, NPI 1548242282

KIMBERLY SUE ELTZROTH (M.D.) is a healthcare provider. based in Salem, Oregon. specializing in Obstetrics & Gynecology Physician. They hold the professional credentials M.D.. They hold a License No. MD60413278 (WA). The NPI Number for KIMBERLY SUE ELTZROTH (M.D.) is 1548242282

Main info

Female
29 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY SUE ELTZROTH (M.D.)
NPI
1548242282
Phone
(503) 399-2444
Address
875 OAK ST SE
Enumeration Date
17 November 2005
Last Update Date
8 October 2021

Doctor Profile

Medical School Name
TUFTS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1997 (29 years ago)
PAC ID
4385549138
Professional Enrollment ID
I20060914000291
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for KIMBERLY SUE ELTZROTH (M.D.)

  • 875, Oak Street Southeast, Salem, Marion County, Oregon, 97301, United States

    SUITE4090

    SALEM, OR 973013985

    Phone: (503) 399-2444

    Fax: (503) 561-6878

    Type: Mailing

  • 441 30TH ST

    ASTORIA, OR 971032807

    Phone: (503) 325-7800

    Fax: (557) 077-5848

    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: 2006-09-14

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
I20060914000291IObstetrics/GynecologyORTBD

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 97301)

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Reviews

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Frequently asked questions

How is KIMBERLY SUE ELTZROTH (M.D.) identified in CMS data?
CMS-hosted NPPES data lists KIMBERLY SUE ELTZROTH (M.D.) with NPI 1548242282.
Can I rely on KIMBERLY SUE ELTZROTH (M.D.) being an active provider?
As of the registry snapshot, KIMBERLY SUE ELTZROTH (M.D.) is marked active.
What taxonomy line describes KIMBERLY SUE ELTZROTH (M.D.)?
For research purposes, treat KIMBERLY SUE ELTZROTH (M.D.) as Obstetrics & Gynecology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is KIMBERLY SUE ELTZROTH (M.D.) based?
KIMBERLY SUE ELTZROTH (M.D.) is tied to Salem, Oregon in the data we show; additional addresses may exist on the full record.
Why does KIMBERLY SUE ELTZROTH (M.D.) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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