Mt. Scott Ear, Nose and Throat – Otolaryngology/Facial Plastic Surgery Physician, NPI 1386754398
Otolaryngology/Facial Plastic Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Mt. Scott Ear, Nose and Throat
9280 SE SUNNYBROOK BLVD STE 300
CLACKAMAS, OR 970159353
Phone: (503) 233-5548
Fax: (503) 230-1009
Type: Location
Southeast 91st Avenue, Lents, Portland, Metro, Multnomah County, Oregon, 97266, United States
SUITE 200
PORTLAND, OR 972666756
Phone: (503) 233-5548
Fax: (503) 230-1009
Type: Mailing
10151 SE SUNNYSIDE RD STE 240
CLACKAMAS, OR 970155774
Phone: (503) 233-5548
Fax: (866) 663-1070
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.
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 |
|---|---|---|---|---|
| O20040817001428 | O | Clinic/Group Practice | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97015)
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