POLLY M SEPULVADO M.D.
NPI 1366433781
Internal Medicine in Roseburg, OR

Q: What is Polly Sepulvado's NPI number?

The NPI number for Polly Sepulvado is 1366433781. It was assigned to this individual provider in the NPPES registry on November 3, 2005.

Q: What is Polly Sepulvado'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 Polly Sepulvado was last updated on December 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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 November 03, 2005PECOS EnrolledAccepts Medicare Assignment

150 NE KENNETH FORD DR, ROSEBURG, OR 97470(416) 729-5965(541) 492-2060 Get Directions Write a Review

NPPES record last updated: December 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Polly M Sepulvado M.d. NPPES

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

POLLY M SEPULVADO M.D. (NPI 1366433781) is an individual internal medicine provider in Roseburg, Oregon, licensed in Oregon (MD16468) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS, is affiliated with Mercy Medical Center, and is a graduate of Louisiana State University School Of Medicine In New Orleans (1974).

NPPES Registry Identity

NPI1366433781

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NamePOLLY M SEPULVADOCredential: M.D.

Location Address150 NE KENNETH FORD DRRoseburg, OR 97470-1042

Mailing Address573 Ne Stephens StRoseburg, OR 97470-3150 · (541) 677-2432 · Fax (541) 957-1131

Phone(416) 729-5965

Fax(541) 492-2060

Sole ProprietorYes

Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 1974

Enumeration DateNovember 3, 2005

Last NPPES UpdateDecember 9, 2024

NPPES CertifiedDecember 9, 2024

✔ NPI 1366433781 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 · MD16468

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 ListedInternal Medicine · RheumatologyTaxonomy 207RR0500X · License MD16468 (OR)

150 NE KENNETH FORD DR, Roseburg, OR 97470

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Other Identifiers 1

Medicaid005129OR

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Polly M Sepulvado M.d. 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.

PECOS PAC ID6204978778

PECOS Enrollment IDI20100121000390

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.

Mercy Medical Center

Acute Care Hospitals · Roseburg, OR

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number380027

Location2700 NW Stewart ParkwayRoseburg, OR 97471 · Douglas County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97470 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

$126.25 typical visit price

range $54.96 – $166.64

Typical copayment $31.56 (range $13.74 – $41.66)

Most-billed visit code 99204

Established Patient

$97.16 typical visit price

range $17.68 – $136.19

Typical copayment $24.29 (range $4.42 – $34.04)

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.

MISHA MARIE PEEL DO

Family Medicine