GATEWAY TO REJUVENATION
NPI 1407388812
Community/Behavioral Health in Portland, OR

Q: What is Gateway To Rejuvenation's NPI number?

The NPI number for Gateway To Rejuvenation is 1407388812. It was assigned to this organization in the NPPES registry on April 3, 2017.

Q: What is Gateway To Rejuvenation's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Active since April 03, 2017

1312 E BURNSIDE ST, PORTLAND, OR 97214(503) 205-1669 Get Directions Write a Review

NPPES record last updated: April 3, 2017. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Gateway To Rejuvenation NPPES

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

GATEWAY TO REJUVENATION (NPI 1407388812) is a healthcare organization registered as a community/behavioral health in Portland, Oregon and active in the NPI registry since April 2017. The organization lists Omolola A Elliott, Therapist, as its authorized official.

NPPES Registry Identity

NPI1407388812

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NameGATEWAY TO REJUVENATION

Location Address1312 E BURNSIDE STPortland, OR 97214-1424

Mailing Address3439 Ne Sandy Blvd Ste 216Portland, OR 97232-1959 · (503) 205-1669

Phone(503) 205-1669

Organization SubpartNo

Authorized OfficialOmolola A ElliottTherapist · (971) 212-3146

Enumeration DateApril 3, 2017

✔ NPI 1407388812 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

License✔ Licensed in OR · L7113

Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

1312 E BURNSIDE ST, Portland, OR 97214

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gateway To Rejuvenation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Gateway To Rejuvenation, which bills Medicare for the services this clinician delivers.

Clinician (1)

Omolola Elliott, LCSW

Clinical Social Worker

NPI 1285174680

1312 E BURNSIDE ST
Portland, OR 97214

(503) 205-1669

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Gateway To Rejuvenation's NPI number?

The NPI number for Gateway To Rejuvenation is 1407388812. It was assigned to this organization in the NPPES registry on April 3, 2017.

Where is Gateway To Rejuvenation located?

Gateway To Rejuvenation is located at 1312 E Burnside St, Portland, OR 97214. The listed phone number is (503) 205-1669.

What is Gateway To Rejuvenation's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Is Gateway To Rejuvenation enrolled in Medicare?

Yes. Gateway To Rejuvenation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Gateway To Rejuvenation?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Gateway To Rejuvenation. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Gateway To Rejuvenation accept?

Health plans from Moda Health Plan, Inc. list Gateway To Rejuvenation as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gateway To Rejuvenation was last updated on April 3, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.