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READE OTTO-MOUDRY MD
NPI 1245178417
Student in an Organized Health Care Education/Training Program in Portland, OR

Active since March 23, 2026PECOS Enrolled
3181 SW SAM JACKSON PARK RD # OR97239, PORTLAND, OR 97239(503) 494-8311 Get Directions Write a Review

NPPES record last updated: March 23, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Reade Otto-moudry Md NPPES

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

READE OTTO-MOUDRY MD (NPI 1245178417) is an individual student in an organized health care education/training program in Portland, Oregon and active in the NPI registry since March 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245178417
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameREADE OTTO-MOUDRYCredential: MD
Location Address3181 SW SAM JACKSON PARK RD # OR97239Portland, OR 97239-3098
Mailing Address308 Cascadnac AveWhite River Junction, VT 05001-8114 · (607) 592-8001
Phone(503) 494-8311
Sole ProprietorNo
Enumeration DateMarch 23, 2026
NPPES CertifiedMarch 21, 2026
✔ NPI 1245178417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3181 SW SAM JACKSON PARK RD # OR97239, Portland, OR 97239
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Reade Otto-moudry 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.

Other Providers at the Same Location NPPES

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

TEJAL HEMANT PANDHARPURKAR BA
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD # OR97239
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 Reade Otto-moudry's NPI number?

The NPI number for Reade Otto-moudry is 1245178417. It was assigned to this individual provider in the NPPES registry on March 23, 2026.

Where is Reade Otto-moudry located?

Reade Otto-moudry practices at 3181 SW Sam Jackson Park Rd # Or97239, Portland, OR 97239. The listed phone number is (503) 494-8311.

What is Reade Otto-moudry's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Reade Otto-moudry enrolled in Medicare?

Yes. Reade Otto-moudry is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Reade Otto-moudry was last updated on March 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.