DR. ALYSE MARIE D'AMBROSIA D.M.D.
NPI 1366876757
Dentist - General Practice in Portland, OR
About Dr. Alyse Marie D'ambrosia D.m.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ALYSE MARIE D'AMBROSIA D.M.D. (NPI 1366876757) is an individual general practice provider in Portland, Oregon, licensed in Oregon (D9933) and active in the NPI registry since August 2013. She has opted out of Medicare through January 16, 2028 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Alyse Marie D'ambrosia D.m.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 16, 2020 through January 16, 2028.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97205 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORTLAND, OR 97205
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 Alyse D'ambrosia's NPI number?
The NPI number for Alyse D'ambrosia is 1366876757. It was assigned to this individual provider in the NPPES registry on August 21, 2013.
Where is Alyse D'ambrosia located?
Alyse D'ambrosia practices at 1221 SW Yamhill St Suite 310, Portland, OR 97205. The listed phone number is (503) 227-0958.
What is Alyse D'ambrosia's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Alyse D'ambrosia enrolled in Medicare?
No. Alyse D'ambrosia has opted out of Medicare through January 16, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Alyse D'ambrosia was last updated on April 25, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Dr. Alyse Marie D'ambrosia, D.M.D. · NPI 1366876757
General Practice provider in Portland, Oregon. Individual provider, active in the CMS NPPES registry since August 21, 2013.
## Identity
- **NPI:** 1366876757 (Entity type: Individual)
- **Enumerated:** August 21, 2013
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** D9933 (Oregon)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1221 SW YAMHILL ST, SUITE 310, Portland, OR 97205-2126
- **Phone:** (503) 227-0958
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through January 16, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** April 25, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1366876757) · Data from the CMS NPPES public registry.