ROMAN TOBIAS PETTIGREW DO
NPI 1043914419
Internal Medicine in Portland, OR

Q: What is Roman Pettigrew's NPI number?

The NPI number for Roman Pettigrew is 1043914419. It was assigned to this individual provider in the NPPES registry on March 29, 2023.

Q: What is Roman Pettigrew's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Roman Pettigrew was last updated on May 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 29, 2023PECOS Enrolled

2801 N GANTENBEIN AVE, PORTLAND, OR 97227(503) 413-8407 Get Directions Write a Review

NPPES record last updated: May 28, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 28, 2026, Mar 29, 2023 (2 updates tracked since 2023).

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About Roman Tobias Pettigrew Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROMAN TOBIAS PETTIGREW DO (NPI 1043914419) is an individual internal medicine provider in Portland, Oregon, licensed in Oregon (DO229970) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS, is affiliated with Legacy Good Samaritan Medical Center, and maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1043914419

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameROMAN TOBIAS PETTIGREWCredential: DO

Location Address2801 N GANTENBEIN AVEPortland, OR 97227-1623

Mailing Address5 Nasons Ct Ste 8Kennebunk, ME 04043-7293

Phone(503) 413-8407

Sole ProprietorYes

Medical School CMSUniversity Of New England, College Of Osteo MedicineGraduated 2023

Enumeration DateMarch 29, 2023

Last NPPES UpdateMay 28, 20262 updates tracked since enumeration

NPPES CertifiedMay 28, 2026

✔ NPI 1043914419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in OR · DO229970

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2801 N GANTENBEIN AVE, Portland, OR 97227

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Secondary Practice Location 1

Location 11015 NW 22nd AvePortland, OR 97210-3025 · Phone (503) 413-8401

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Roman Tobias Pettigrew Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7416312996

PECOS Enrollment IDI20260611001030

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Legacy Good Samaritan Medical Center

Acute Care Hospitals · Portland, OR

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380017

Location1015 NW 22nd Avenue, W121Portland, OR 97210 · Multnomah County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97227 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$134.16 typical visit price

range $58.99 – $176.88

Typical copayment $33.54 (range $14.74 – $44.22)

Most-billed visit code 99204

Established Patient

$103.51 typical visit price

range $19.32 – $144.79

Typical copayment $25.87 (range $4.83 – $36.19)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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