BYRON V ETTA MD
NPI 1174971402
Emergency Medicine in Portland, OR
About Byron V Etta Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BYRON V ETTA MD (NPI 1174971402) is an individual emergency medicine provider in Portland, Oregon, licensed in California (A166911) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS, is affiliated with Red Lake Hospital, and maintains a secondary practice location in Delano.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Byron V Etta Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
6Medicare enrollment records show Byron Etta reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Browning, MT 59417
- Reassigned Medicare billing, Texas enrollment
- 306 clinicians in this Medicare group
Delano, CA 93215
- Reassigned Medicare billing, California enrollment
- 1,204 clinicians in this Medicare group
Rock Point, AZ 86545
- Reassigned Medicare billing, Texas enrollment
- 476 clinicians in this Medicare group
Manderson, SD 57756
- Reassigned Medicare billing, Texas enrollment
- 426 clinicians in this Medicare group
Rosebud, SD 57570
- Reassigned Medicare billing, Texas enrollment
- 386 clinicians in this Medicare group
Red Lake, MN 56671
- Reassigned Medicare billing, Texas enrollment
- 66 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 5
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Red Lake Hospital
Acute Care Hospitals · Redlake, MNPhs Indian Hospital At Rosebud
Acute Care Hospitals · Rosebud, SDPhysician 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.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
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 Byron Etta's NPI number?
The NPI number for Byron Etta is 1174971402. It was assigned to this individual provider in the NPPES registry on May 26, 2016.
Where is Byron Etta located?
Byron Etta practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-5678.
What is Byron Etta's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Byron Etta enrolled in Medicare?
Yes. Byron Etta is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Byron Etta's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Byron Etta reassigns Medicare benefits to 6 organizations: U S Health Dept Of Health & Human Services (Browning, MT), Cep America-California (Delano, CA), Dhhs Phs Naihs Chinle Comprehensive Health Care Facility (Rock Point, AZ), Pine Ridge Indian Health Service Hospital (Manderson, SD), Rosebud Indian Health Service (Rosebud, SD) and 1 more organization, listed in the Medicare section above. Each 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 Byron Etta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Byron Etta affiliated with any hospitals?
According to CMS data, Byron Etta is affiliated with Red Lake Hospital and Phs Indian Hospital At Rosebud.
When was this NPI record last updated?
The NPPES record for Byron Etta was last updated on January 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Byron V Etta, MD · NPI 1174971402
Emergency Medicine physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since May 26, 2016.
## Identity
- **NPI:** 1174971402 (Entity type: Individual)
- **Enumerated:** May 26, 2016
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** A166911 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3181 SW SAM JACKSON PARK RD, Portland, OR 97239-3011
- **Phone:** (503) 494-5678 · **Fax:** (949) 732-4572
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): U S Health Dept Of Health & Human Services (NPI 1861409955, Browning, MT); Cep America-California (NPI 1598534216, Delano, CA); Dhhs Phs Naihs Chinle Comprehensive Health Care Facility (NPI 1154344133, Rock Point, AZ); Pine Ridge Indian Health Service Hospital (NPI 1487701348, Manderson, SD); Rosebud Indian Health Service (NPI 1194757369, Rosebud, SD); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Oregon Health Sciences University School Of Medicine, class of 2017
## Record status
- **NPPES last updated:** January 5, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1174971402) · Data from the CMS NPPES public registry.