EAST PAVILION SURGERY CENTER
NPI 1316449168
Clinic/Center - Ambulatory Surgical in Portland, OR

NPI Status: Active since March 07, 2018

Contact Information

9135 SW BARNES RD STE 161
PORTLAND, OR
ZIP 97225
Phone: (971) 339-7791

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 38D2166408
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 05-15-2027

About EAST PAVILION SURGERY CENTER

This page provides the complete NPI Profile along with additional information for East Pavilion Surgery Center, a provider established in Portland, Oregon operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1316449168 assigned on March 2018. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The provider's is doing business as East Pavilion Surgery Center. The authorized official of this NPI record is Mr. Bruce Dudley (Chief Administrative Officer)

NPI
1316449168
Provider Legal Name
SURGERY CENTER AT ST. VINCENT, LLC
Other Organization Name
EAST PAVILION SURGERY CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
9135 SW BARNES RD STE 161 PORTLAND, OR 97225
Location Phone
(971) 339-7791
Mailing Address
9135 SW BARNES RD STE 161 PORTLAND, OR 97225
Mailing Phone
(971) 339-7791
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-07-2018
Last Update Date
07-16-2019
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • KP OR Bronze 6000 - EPO
  • KP OR Bronze HSA 7100 - EPO
  • KP OR Gold 0 - EPO
  • KP OR Gold 1750 - EPO
  • KP OR Silver 3000 - EPO
  • KP OR Silver 4000 - EPO
  • KP Oregon Standard Bronze Plan - EPO
  • KP Oregon Standard Gold Plan - EPO
  • KP Oregon Standard Silver Plan - EPO
  • KP OR Family Dental - $100 Ded - EPO
  • KP OR Family Dental - $1000 - EPO
  • KP OR Family Dental - $1000/$50 Ded - EPO
  • Connect 1500 Gold - EPO
  • Connect 6000 Silver - EPO
  • Connect 9800 Bronze - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. BRUCE DUDLEY

Authorized Official Title
CHIEF ADMINISTRATIVE OFFICER
Authorized Official Phone
(971) 339-7791

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Crushing of stone of ureter with insertion of stent using an endoscope

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

This service was performed 44 times for 40 patients

Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm

This procedure involves using a thin, flexible tool called an endoscope to examine and remove a growth in your bladder and urethra. The growth size ranges from 2.0-5.0 cm. This is done to ensure your urinary system functions properly.

This service was performed 25 times for 22 patients

Exploration of nasal sinus using an endoscope

Exploration of the nasal sinus using an endoscope is a procedure where a thin, flexible tube with a light and camera attached is inserted into the nose. This allows the doctor to view and examine the sinuses in detail, aiding in the diagnosis and treatment of sinus issues.

This service was performed 39 times for 21 patients

Imaging of urinary tract following injection of a contrast agent

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

This service was performed 49 times for 41 patients

Incision of nasal sinus using an endoscope

This procedure, called endoscopic sinus surgery, involves using a thin, flexible tube with a light and camera on the end, known as an endoscope. It's inserted into the nasal passages to view and remove obstructions in the sinuses, helping to alleviate symptoms.

This service was performed 21 times for 13 patients

Injection of implant material beneath lining of bladder and/or urethra using an endoscope

This is a procedure where a substance is inserted under the bladder or urethra lining using a special instrument called an endoscope. This helps to support these areas and improve their function. It's done in a safe, controlled medical environment.

This service was performed 17 times for 16 patients

Insertion of stent in ureter using an endoscope

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

This service was performed 26 times for 20 patients

Partial removal of breast

A partial removal of the breast, also known as a lumpectomy, involves taking out a portion of the breast tissue to eliminate concerning cells. It's typically performed when the problem area is limited in size. This procedure helps to preserve most of the breast's appearance while aiming to remove all the unhealthy cells.

This service was performed 20 times for 19 patients

Removal of nasal air passage under lining tissue

This procedure, often done to improve breathing or address sinus issues, involves the removal of tissue from the lining of the nasal air passage. It's performed under anesthesia and recovery time varies based on individual health status.

This service was performed 79 times for 40 patients

Removal of nasal sinus tissue using an endoscope

This procedure, known as endoscopic sinus surgery, involves using a thin, flexible tube with a light and camera to view and remove problematic nasal sinus tissue. It helps to alleviate sinus issues and improve breathing.

This service was performed 29 times for 17 patients

Removal of prostate gland using an electrocautery knife through urethra with control of bleeding using an endoscope

This procedure involves the careful removal of a small gland located in the lower body using a special heated knife, inserted through a natural body passage. An endoscope, a thin tube with a light and camera, helps to manage any bleeding. The aim is to alleviate discomfort and improve overall health.

This service was performed 49 times for 49 patients

Removal or exploration of parathyroid glands

The procedure for removal or exploration of parathyroid glands involves a surgeon making a small incision in the neck to locate and remove one or more of the tiny parathyroid glands. These glands control calcium levels in the body. This procedure helps treat conditions like hyperparathyroidism.

This service was performed 12 times for 12 patients

Repair of groin hernia (5 years or older)

Repair of a groin hernia is a procedure aimed at fixing an abnormal bulge that can occur in the area between your abdomen and thigh. This condition happens when tissue pushes through a weak spot in your lower abdominal wall. The repair procedure returns this tissue back to its proper place.

This service was performed 13 times for 11 patients

Repair of herniated rectum into vaginal wall

This procedure involves correcting a physical condition where part of the rectum bulges into the vaginal area. It's done by repositioning the rectum and strengthening the tissue between the two areas to prevent recurrence.

This service was performed 11 times for 11 patients

Repair of nasal passage

Repair of the nasal passage is a surgical procedure aimed at correcting problems in your nose that cause difficulty in breathing or other discomforts. It can address issues like a deviated septum, nasal polyps, or chronic sinusitis. The goal is to improve your quality of life.

This service was performed 16 times for 15 patients

Reshaping of nasal cartilage

Reshaping of nasal cartilage, also known as rhinoplasty, is a surgical procedure to modify the structure of the nose for aesthetic or functional purposes. It involves adjusting the cartilage and bone in the nose to achieve the desired shape or to improve breathing.

This service was performed 41 times for 41 patients

Shock wave crushing of kidney stones

Shock wave crushing of kidney stones, also known as Extracorporeal Shock Wave Lithotripsy (ESWL), is a non-invasive treatment. It involves the use of sound waves to break down kidney stones into small pieces that can easily pass through your urinary tract.

This service was performed 12 times for 11 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
38D2166408
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
May 16, 2025
Certificate Expiration Date
May 15, 2027
Laboratory Director
ANAND JAIN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to East Pavilion Surgery Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1316449168, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
1
Doubled → 2
Pos 4
6
Unchanged
Pos 5
4
Doubled → 8
Pos 6
4
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
1
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 4 → 8 9 → 18 → 9 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 2 + 6 + 8 + 4 + 1 + 8 + 1 + 1 + 2 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1316449168.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1316449168, enumerated as an "organization" on March 07, 2018.

The provider is located at 9135 SW BARNES RD STE 161 PORTLAND, OR 97225 and the phone number is (971) 339-7791.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Kaiser Permanente and Providence Health Plan. Please consult your insurance carrier or call the provider to verify.