EVERGREEN PROSTHETICS AND ORTHOTICS, LLC – Prosthetic/Orthotic Supplier, NPI 1235595760

EVERGREEN PROSTHETICS AND ORTHOTICS, LLC is a healthcare provider. based in Oregon city, Oregon. specializing in Prosthetic/Orthotic Supplier. The NPI Number for EVERGREEN PROSTHETICS AND ORTHOTICS, LLC is 1235595760

Main info

Organization
Name
EVERGREEN PROSTHETICS AND ORTHOTICS, LLC
NPI
1235595760
Phone
(503) 765-5081
Address
911 MAIN ST STE 100
Authorized Official
TIMOTHY L O'NEILL OWNER
Enumeration Date
13 January 2016
Last Update Date
1 November 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:10State licenses:0Digital endpointsOther names

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Provider Addresses for EVERGREEN PROSTHETICS AND ORTHOTICS, LLC

  • 911 MAIN ST STE 100

    OREGON CITY, OR 970451853

    Phone: (503) 765-5081

    Fax: (971) 316-1553

    Type: Mailing

  • Southwest Nimbus Avenue, Greenway, Beaverton, Metro, Washington County, Oregon, 97223, United States

    BEAVERTON, OR 970087111

    Phone: (877) 971-7272

    Fax: (971) 727-3162

    Type: Mailing

  • Urgent Care Northwest, 2120, Exchange Street, Uppertown, Astoria, Clatsop County, Oregon, 97103, United States

    SUITE 204

    ASTORIA, OR 971033365

    Phone: (888) 574-5934

    Type: Location

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: 2016-06-11

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-10-31 (592 days ago).

Enrollment records

1

Earliest due date

2024-10-31

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
O20160611000014OProsthetic PersonnelOR2024-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 97045)

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Reviews

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Frequently asked questions

What number should I use to identify EVERGREEN PROSTHETICS AND ORTHOTICS, LLC for billing?
Administrative and clinical systems typically use NPI 1235595760 for EVERGREEN PROSTHETICS AND ORTHOTICS, LLC.
Should I treat EVERGREEN PROSTHETICS AND ORTHOTICS, LLC as an active provider?
Patients and plans typically see EVERGREEN PROSTHETICS AND ORTHOTICS, LLC as active in the national extract.
What type of care does EVERGREEN PROSTHETICS AND ORTHOTICS, LLC provide?
EVERGREEN PROSTHETICS AND ORTHOTICS, LLC's profile centers on Prosthetic/Orthotic Supplier. Clinical services aligned with this taxonomy classification.
What geographic area is tied to EVERGREEN PROSTHETICS AND ORTHOTICS, LLC?
EVERGREEN PROSTHETICS AND ORTHOTICS, LLC is associated with Oregon City, Oregon in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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