NICHOLAS PHILLIPS (MD) – Sports Medicine (Emergency Medicine) Physician, NPI 1770803892
Sports Medicine (Emergency Medicine) Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
88 SPORTS MEDICINE in OR
Provider Addresses for NICHOLAS PHILLIPS (MD)
845 SW 30TH ST.
SAMARITAN ATHLETIC MEDICINE CENTER
CORVALLIS, OR 97331
Phone: (541) 768-7700
Fax: (541) 768-9784
Type: Mailing
PO BOX 1189
CORVALLIS, OR 973391189
Phone:
Type: Mailing
845 SW 30TH ST
CORVALLIS, OR 973318629
Phone: (541) 768-7700
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $246.
Total Amount is formed as General ($246) + Research ($0) + Ownership ($0) = $246.
Last reported payment date: 2024-12-06 • Largest payer in this snapshot: DJO, LLC ($246).
Total Amount
$246
General + Research + Ownership
Payments
8
Total payment records
General Amount
$246
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| DJO, LLC | $246 |
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: 2015-01-08
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150108000265 | I | Sports Medicine | 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 |
|---|---|---|---|---|
| J7318 | Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg | 3,240 | 31 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 324 | 61 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 283 | 59 | $0 |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 131 | 79 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 96 | 72 | $0 |
Insurance plans in this area (ZIP 97331)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| SPORTS MEDICINE | OR | 73562 | X-ray of knee, 3 views | 17 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| Physical Therapist In Private Practice | MT | |
| P S Y C H I A T R Y | OR | |
| Physician Assistant | OR | |
| - | OR | |
| - | OR | |
| Occupational Therapist In Private Practice | OR | |
| - | OR | |
| O B S T E T R I C S/ G Y N E C O L O G Y | PA | |
| - | OR |
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