MR. TYLER SCOTT MITTELSTAEDT (NPI# 1053678284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053678284 |
| Entity Type | Individual |
| Full Name | MR. TYLER SCOTT MITTELSTAEDT |
| Credential | MD-MPH |
| Practice Address |
9200 Se 91st Ave Ste 320 Portland OR 97086-3756 |
| Practice Telephone | (503) 353-3005 |
| Practice Fax Number | 5035463201 |
| Mailing Telephone | (503) 353-3005 |
| Mailing Fax Number | 5035463201 |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2017-08-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | MD183147 | OR | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
9200 SE 91ST AVE STE 320 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97086-3756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063803674 | Brandy Lynn Sajovic | Case Manager/Care Coordinator | 10822 Se 82nd Ave., Suite K, Happy Valley, OR 97086 | 2015-02-18 |
| 1851795561 | Tyler Lundquist | Chiropractor | 16144 Se Happy Valley Town Center Dr #214, Happy Valley, OR 97086 | 2014-10-09 |
| 1184040644 | Rui O'reilly | Massage Therapist | 10911 Se Alyssa Dr, Happy Valley, OR 97086 | 2014-03-07 |
| 1083036990 | Laura Dillard | Registered Nurse | 10822 Se 82nd Ave, Happy Valley, OR 97086 | 2014-01-11 |
| 1699027672 | Clackamas Town Dental, LLC | Dentist | 9225 Se Sunnyside Road, Clackamas, OR 97086 | 2012-10-15 |
| 1750639233 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 11800 Se 82nd Avenue, Happy Valley, OR 97086 | 2012-08-15 |
| 1962641654 | Mt Scott Vision and Ocular Imaging Center PC | Optometrist | 9300 Ne 91st Ave, Suite 100, Happy Valley, OR 97086 | 2009-02-19 |
| 1598916546 | Cynthia Sue Weaver | Nurse Practitioner | 9300 Se 91 Ave., Suite 400, Portland, OR 97086 | 2008-10-08 |
| 1396928776 | Cary Ann Fardal | Dietitian, Registered | 13444 Se Piper Dr, Happy Valley, OR 97086 | 2007-12-09 |
| 1689873242 | New Seasons Market - Happy Valley | Pharmacy | 15861 Se Happy Valley Town Center Dr., Happy Valley, OR 97086 | 2007-07-13 |
| Find all providers in zip 97086 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386168029 | Northwest Minimally Invasive Surgery, LLC | Surgery | 2222 Nw Lovejoy St Ste 322, Portland, OR 97210-5101 | 2017-08-02 |
| 1366897399 | Andreas Hennig | Surgery | 783 Nw Naito Pkwy Apt 502, Portland, OR 97209-4755 | 2016-04-27 |
| 1871989467 | Cameron Cangelose | Surgery | 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239-3098 | 2015-04-09 |
| 1396157962 | Fernando Leon | Surgery | 2221 Sw First Ave Apt 2322, Portland, OR 97201-5023 | 2014-05-29 |
| 1114337466 | Thomas B Knowles | Surgery | 1130 Nw 22nd Ave Ste 500, Portland, OR 97210-2976 | 2014-05-07 |
| 1659714160 | Sean Tyler Watters | Surgery | 5050 Ne Hoyt St Ste 651, Portland, OR 97213 | 2013-04-15 |
| 1528301926 | Vincent A. Reger, Md PC | Surgery | 9155 Sw Barnes Rd Ste 406, Portland, OR 97225-6641 | 2013-04-03 |
| 1235496944 | Lori Cardwell | Surgery | Ohsu Gastrointestinal & General Surgery At Chh, 3303 Sw Bond Avenue, Portland, OR 97239-4501 | 2012-04-19 |
| 1285990721 | John David Webber | Surgery | 12155 Sw Wildwood St, Portland, OR 97224-2919 | 2012-04-10 |
| 1912294422 | Lauren Marie Wancata | Surgery | 3181 Sw Sam Jackson Park Rd # 590, Portland, OR 97239 | 2011-07-05 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.