ROGER REYNOLDS (D.O.) – Family Medicine Physician, NPI 1689682254

ROGER REYNOLDS (D.O.) is a healthcare provider. based in Forest grove, Oregon. specializing in Family Medicine Physician. They hold the professional credentials D.O.. They hold a License No. DO18450 (OR). The NPI Number for ROGER REYNOLDS (D.O.) is 1689682254

Main info

Male
44 Years Of Experience
Accepts Medicare Assignment
Name
ROGER REYNOLDS (D.O.)
NPI
1689682254
Phone
(503) 357-2136
Address
1825 MAPLE ST
Enumeration Date
3 August 2006
Last Update Date
10 January 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5036811177
Graduation Year
1982 (44 years ago)
PAC ID
5092754549
Group Practice PAC ID
7416173414
Professional Enrollment ID
I20100108000490
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for ROGER REYNOLDS (D.O.)

  • Maple Street Clinic, 1825, Maple Street, Forest Grove, Metro, Washington County, Oregon, 97116, United States

    FOREST GROVE, OR 971161939

    Phone: (503) 357-2136

    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)

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: 2010-01-08

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
I20100108000490IFamily PracticeORTBD

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 97116)

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Provider's Procedures

ROGER REYNOLDS (D.O.) performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEOR81002Urinalysis, manual test2523

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: 7416173414View full group profile
NameSpecialtyState
Internal Medicine, Sleep MedicineNC
P A T H O L O G YOR
Nurse PractitionerOR
Internal MedicineNY
Family PracticeOR
Internal MedicineNJ
Cardiovascular Disease (Cardiology)OR
Diagnostic RadiologyOR
N E U R O L O G YOR
-OR

Reviews

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Frequently asked questions

What number should I use to identify ROGER REYNOLDS (D.O.) for billing?
Administrative and clinical systems typically use NPI 1689682254 for ROGER REYNOLDS (D.O.).
Is ROGER REYNOLDS (D.O.) currently accepting referrals based on NPI status?
Registry metadata lists ROGER REYNOLDS (D.O.) as active.
How should patients interpret ROGER REYNOLDS (D.O.)'s specialty?
The extract shows Family Medicine Physician for ROGER REYNOLDS (D.O.). Clinical services aligned with this taxonomy classification.
Is ROGER REYNOLDS (D.O.) tied to Forest Grove, Oregon?
If you are local to Forest Grove, Oregon, ROGER REYNOLDS (D.O.) may be relevant to your search.
Can I export ROGER REYNOLDS (D.O.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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