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DAKOTA WOLF CROCKER MD
NPI 1164165346
Pediatrics in Portland, OR

Active since April 15, 2022PECOS Enrolled
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 494-8211 Get Directions Write a Review

NPPES record last updated: July 9, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 9, 2025, May 20, 2025, Apr 15, 2022 (3 updates tracked since 2022).

About Dakota Wolf Crocker Md NPPES

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

DAKOTA WOLF CROCKER MD (NPI 1164165346) is an individual pediatrics provider in Portland, Oregon, licensed in Oregon (MD226307) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164165346
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDAKOTA WOLF CROCKERCredential: MD
Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3011
Mailing Address3181 Sw Sam Jackson Park RdPortland, OR 97239-3011 · (503) 494-8311
Phone(503) 494-8211
Sole ProprietorYes
Enumeration DateApril 15, 2022
Last NPPES UpdateJuly 9, 20253 updates tracked since enumeration
NPPES CertifiedJuly 9, 2025
✔ NPI 1164165346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in OR · MD226307✔ Licensed in OR · PG211350
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3181 SW SAM JACKSON PARK RD, Portland, OR 97239
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dakota Wolf Crocker Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Dakota Crocker reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Professional Services
Same address
General Practice
3181 SW SAM JACKSON PARK RD
Portland, OR 97239
  • Reassigned Medicare billing, Oregon enrollment
  • 2,212 clinicians in this Medicare group
NPI 1376709535 (503) 494-8311

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97239 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
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.

DONALD RICHARD SULLIVAN MD
Internal Medicine (Pulmonary Disease)
3181 SW SAM JACKSON PARK RD, UHN67
PORTLAND, OR 97239
Multnomah County (503) 494-6949
MRS. ANJALEE NIX ROWE NP
Nurse Practitioner (Acute Care)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-3988
REEM HASAN MD
Internal Medicine
3181 SW SAM JACKSON PARK RD, PPV 350
PORTLAND, OR 97239
Multnomah County (503) 494-8562
DR. AMANDA D BALL PSY.D
Psychologist (Clinical)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
SUNSHINE WELSCH LMT
Massage Therapist
3181 SW SAM JACKSON PARK RD, 7D19
PORTLAND, OR 97239
Multnomah County (503) 494-8349
DR. ROBERT GENE MEALER M.D., PH.D.
Psychiatry & Neurology (Psychiatry)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
GREGORY HALL MD
Radiology (Diagnostic Radiology)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 418-0990
DR. BURHAN AHMED MIAN MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-8311

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dakota Crocker's NPI number?

The NPI number for Dakota Crocker is 1164165346. It was assigned to this individual provider in the NPPES registry on April 15, 2022.

Where is Dakota Crocker located?

Dakota Crocker practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-8211.

What is Dakota Crocker's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Dakota Crocker enrolled in Medicare?

Yes. Dakota Crocker is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Dakota Crocker's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dakota Crocker reassigns Medicare benefits to University Professional Services (Portland, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dakota Crocker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dakota Crocker accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan list Dakota Crocker as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dakota Crocker was last updated on July 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.