DR. MARK D. RELLER (M.D.) – Pediatric Cardiology Physician, NPI 1972548469

DR. MARK D. RELLER (M.D.) is a healthcare provider. based in Portland, Oregon. specializing in Pediatric Cardiology Physician. They hold the professional credentials M.D.. They hold a License No. MD13950 (OR). The NPI Number for DR. MARK D. RELLER (M.D.) is 1972548469

Main info

Male
49 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARK D. RELLER (M.D.)
NPI
1972548469
Phone
(503) 494-2192
Address
707 SW GAINES ST
Enumeration Date
18 June 2006
Last Update Date
18 November 2011

Doctor Profile

Medical School Name
UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Secondary Phone
5034948311
Graduation Year
1977 (49 years ago)
PAC ID
2264410927
Group Practice PAC ID
4880760107
Professional Enrollment ID
I20040709000292
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for DR. MARK D. RELLER (M.D.)

  • Child Development Rehabilitation Center, 707, Southwest Gaines Street, Marquam Hill, Homestead, Portland, Metro, Multnomah County, Oregon, 97239, United States

    CDRC-P

    PORTLAND, OR 972392901

    Phone: (503) 494-2192

    Fax: (503) 494-2824

    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: 2004-07-09

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
I20040709000292ICardiovascular Disease (Cardiology)ORTBD

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

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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 97239)

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Provider's Procedures

DR. MARK D. RELLER (M.D.) performs procedures in Pediatric Cardiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)OR93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report1211

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: 4880760107View full group profile

Reviews

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Frequently asked questions

How do I look up DR. MARK D. RELLER (M.D.) by NPI?
Use NPI 1972548469 when you need to reference DR. MARK D. RELLER (M.D.) in forms, claims, or directories.
Is DR. MARK D. RELLER (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does DR. MARK D. RELLER (M.D.) list a primary specialty?
If you are matching referrals, note Pediatric Cardiology Physician for DR. MARK D. RELLER (M.D.). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. MARK D. RELLER (M.D.)?
The page summarizes Portland, Oregon for DR. MARK D. RELLER (M.D.); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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