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DR. ALEXANDRA CERUTTI BOLOGNESE MD PHD NPI 1356609374


NPI Information

NPI: 1356609374
Provider Name: DR. ALEXANDRA CERUTTI BOLOGNESE, MD, PHD
Classification: Transplant Surgery - 204F00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239
Phone: (503) 494-7810
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DR. Alexandra Cerutti Bolognese, MD, PHD is a transplant surgery in Portland, OR with 12 years of experience. The provider is a surgeon who specializes in transplant surgery. Source: National Uniform Claim Committee DR. Alexandra Cerutti Bolognese, MD, PHD NPI is 1356609374. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
Graduation Year:2012

The provider's business location address is:

3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239-011
Phone: (503) 494-7810
Fax: (503) 494-5292

The NPI 1356609374 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/27/2012 and was last updated on 10/18/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1204F00000XTransplant Surgery73045WISCONSINNo
2208600000XSurgeryMD210833OREGONNo
3208600000XSurgery73045WISCONSINNo
4204F00000XTransplant SurgeryMD210833OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1MD210833OTHEROREGONLICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.