Dr. Mark A. Petroff, M.D.
Plastic Surgery, Plastic Surgery Within the Head and Neck in Lake Oswego, OR. Individual provider (NPI-1).
NPI number1528068129
StatusActive
Last updated in NPPESMar 7, 2023
Details
- NPI
- 1528068129
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mark A. Petroff
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 26, 2005
- Last updated
- Mar 7, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PLASTIC AND RECONSTRUCTIVE SURGERY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2082S0099X | Plastic Surgery, Plastic Surgery Within the Head and Neck | MD15996 | OR | Yes |
Practice location
17720 Jean WaySuite100
Lake Oswego, OR 97035-5394
Phone 503-635-4886 · Fax 503-635-1655
Mailing address
17720 Jean WaySuite100
Lake Oswego, OR 97035-5394
Phone 503-635-4886 · Fax 503-635-1655
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