CTA Pathology – Dermatopathology Physician, NPI 1861533481
Dermatopathology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CTA Pathology
9750 SW NIMBUS AVE
BEAVERTON, OR 970087172
Phone: (503) 906-7300
Type: Location
12254 SW GARDEN PL
TIGARD, OR 972238246
Phone: (503) 906-7300
Type: Location
PO BOX 230457
TIGARD, OR 972810457
Phone: (503) 245-8220
Fax: (503) 249-8219
Type: Mailing
2815 Eastlake Ave E Ste 240
Seattle, WA 981023086
Phone: (503) 906-7300
Type: Location
1633 Medical Center Pt
Colorado Springs, CO 809075700
Phone: (970) 287-4747
Type: Location
3131 S State St Ste 309
Ann Arbor, MI 481081658
Phone: (503) 906-7300
Type: Location
PO BOX 3227
HOUSTON, TX 772533227
Phone: (503) 906-7300
Fax: (503) 245-8219
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2023-10-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-04-30 (39 days ago).
Enrollment records
3
Earliest due date
2026-04-30
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 |
|---|---|---|---|---|
| O20050928001130 | O | Clinic/Group Practice | OR | TBD |
| O20210408001171 | O | Clinic/Group Practice | CO | 2026-04-30 |
| O20231025000262 | O | Clinic/Group Practice | MI | TBD |
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.
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 97008)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.