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DR. MARK A. PETROFF M.D.
NPI 1528068129
Plastic Surgery - Plastic Surgery Within the Head and Neck in Lake Oswego, OR

Active since July 26, 2005PECOS Enrolled
17720 JEAN WAY, SUITE100, LAKE OSWEGO, OR 97035(503) 635-4886(503) 635-1655 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Mark A. Petroff M.d. NPPES

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

DR. MARK A. PETROFF M.D. (NPI 1528068129) is an individual plastic surgery within the head and neck provider in Lake Oswego, Oregon, licensed in Oregon (MD15996) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1528068129
Entity TypeIndividualMale
Primary Taxonomy2082S0099X
Provider Legal NameDR. MARK A. PETROFFCredential: M.D.
Location Address17720 JEAN WAY, SUITE100Lake Oswego, OR 97035-5394
Mailing Address17720 Jean Way, Suite100Lake Oswego, OR 97035-5394 · (503) 635-4886 · Fax (503) 635-1655
Phone(503) 635-4886
Fax(503) 635-1655
Sole ProprietorNo
Enumeration DateJuly 26, 2005
Last NPPES UpdateMarch 7, 2023
✔ NPI 1528068129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic Surgery · Plastic Surgery Within the Head and NeckAllopathic & Osteopathic Physicians
Taxonomy Code2082S0099X
License✔ Licensed in OR · MD15996
Definition
A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them.
17720 JEAN WAY, Lake Oswego, OR 97035
Open in Google Maps ↗

Other Identifiers 2

OtherMD15996OR · State License
Medicaid069609OR

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mark A. Petroff M.d. 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 2

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

LARRY BOWDEN DMD
Dentist (General Practice)
17720 JEAN WAY
LAKE OSWEGO, OR 97035
Clackamas County (503) 675-7300
MARK A. PETROFF, MD PC
Plastic Surgery
17720 JEAN WAY, #100
LAKE OSWEGO, OR 97035
Clackamas County (503) 635-4886

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 Mark Petroff's NPI number?

The NPI number for Mark Petroff is 1528068129. It was assigned to this individual provider in the NPPES registry on July 26, 2005.

Where is Mark Petroff located?

Mark Petroff practices at 17720 Jean Way Suite100, Lake Oswego, OR 97035. The listed phone number is (503) 635-4886.

What is Mark Petroff's specialty?

The primary specialty registered for this NPI is Plastic Surgery, specializing in Plastic Surgery Within the Head and Neck, with taxonomy code 2082S0099X.

Is Mark Petroff enrolled in Medicare?

Yes. Mark Petroff is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mark Petroff was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.