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DR. EUGENE PENDLETON NICHOLSON IV M.D.
NPI 1710197991
Pediatrics in Portland, OR

Active since May 23, 2007PECOS Enrolled
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 494-8311 Get Directions Write a Review

NPPES record last updated: December 5, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Eugene Pendleton Nicholson Iv M.d. NPPES

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

DR. EUGENE PENDLETON NICHOLSON IV M.D. (NPI 1710197991) is an individual pediatrics provider in Portland, Oregon, licensed in Oregon (AE33090453635) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710197991
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. EUGENE PENDLETON NICHOLSON IVCredential: M.D.
Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3011
Mailing Address707 Sw Gaines St, Cdrc-pPortland, OR 97239-2901 · (503) 418-5263
Phone(503) 494-8311
Sole ProprietorNo
Enumeration DateMay 23, 2007
Last NPPES UpdateDecember 5, 2008
✔ NPI 1710197991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in OR · AE33090453635
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3181 SW SAM JACKSON PARK RD, Portland, OR 97239
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Eugene Pendleton Nicholson Iv 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.

Medicare Billing Reassignment

Medicare enrollment records show Eugene Nicholson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kaiser Foundation Health Plan Of The Northwest
2.3 mi
General Practice
1035 NW NORTHRUP ST
Portland, OR 97209
  • Reassigned Medicare billing, Oregon and Washington enrollments
  • Also billed through NPI 1871848457 (Washington)
  • 3,207 clinicians in this Medicare group
NPI 1649722034 (800) 813-2000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97239 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
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.

DONALD RICHARD SULLIVAN MD
Internal Medicine (Pulmonary Disease)
3181 SW SAM JACKSON PARK RD, UHN67
PORTLAND, OR 97239
Multnomah County (503) 494-6949
MRS. ANJALEE NIX ROWE NP
Nurse Practitioner (Acute Care)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-3988
REEM HASAN MD
Internal Medicine
3181 SW SAM JACKSON PARK RD, PPV 350
PORTLAND, OR 97239
Multnomah County (503) 494-8562
DR. AMANDA D BALL PSY.D
Psychologist (Clinical)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
SUNSHINE WELSCH LMT
Massage Therapist
3181 SW SAM JACKSON PARK RD, 7D19
PORTLAND, OR 97239
Multnomah County (503) 494-8349
DR. ROBERT GENE MEALER M.D., PH.D.
Psychiatry & Neurology (Psychiatry)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
GREGORY HALL MD
Radiology (Diagnostic Radiology)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 418-0990
DR. BURHAN AHMED MIAN MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-8311

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 Eugene Nicholson's NPI number?

The NPI number for Eugene Nicholson is 1710197991. It was assigned to this individual provider in the NPPES registry on May 23, 2007.

Where is Eugene Nicholson located?

Eugene Nicholson practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-8311.

What is Eugene Nicholson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Eugene Nicholson enrolled in Medicare?

Yes. Eugene Nicholson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Eugene Nicholson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Eugene Nicholson reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Northwest (Portland, OR). The 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 Eugene Nicholson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Eugene Nicholson was last updated on December 5, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.