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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SALLY HAFEZ KORDAB MD
NPI 1710628292
Pediatrics in Beaverton, OR

Active since April 06, 2022PECOS Enrolled
4855 SW WESTERN AVE, BEAVERTON, OR 97005(800) 813-2000 Get Directions Write a Review

NPPES record last updated: September 2, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 2, 2026, Jun 10, 2025, Apr 6, 2022 (3 updates tracked since 2022).

About Sally Hafez Kordab Md NPPES

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

SALLY HAFEZ KORDAB MD (NPI 1710628292) is an individual pediatrics provider in Beaverton, Oregon, licensed in Oregon (MD229975) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of University Of Texas Medical Branch At Galveston (2022).

NPPES Registry Identity

NPI1710628292
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameSALLY HAFEZ KORDABCredential: MD
Location Address4855 SW WESTERN AVEBeaverton, OR 97005-3460
Mailing Address500 Ne Multnomah St Ste 100Portland, OR 97232-2099 · (800) 813-2000
Phone(800) 813-2000
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical Branch At GalvestonGraduated 2022
Enumeration DateApril 6, 2022
Last NPPES UpdateSeptember 2, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2026
✔ NPI 1710628292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in OR · MD229975✔ Licensed in WA · MD.MD.701260
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.
4855 SW WESTERN AVE, Beaverton, OR 97005
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Harbor Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sally Hafez Kordab Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951749886
PECOS Enrollment IDI20260824003933
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 Sally Kordab reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Beaverton Rehab & Specialty Care, LLC
1.0 mi
Skilled Nursing Facility
11850 SW ALLEN BLVD
Beaverton, OR 97005
  • Reassigned Medicare billing, Oregon and Washington enrollments
  • Medicare enrollment name: Kaiser Foundation Health Plan Of The Northwest
  • Also billed through NPI 1184786527 (Washington)
  • 3,207 clinicians in this Medicare group
NPI 1366469330 (503) 646-7164

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 97005 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.

MRS. RANDEEP KAUR DA
Dental Assistant
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 626-4148
CHANNA V HANG PA
Physician Assistant
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 813-2000
MEDHA CHUNDURU MD
Family Medicine
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (800) 813-2000
MARYLOU STRONG
Physical Therapist
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 520-4950
BRADLEY RAY PLANT DPT, CSCS
Physical Therapist
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (800) 813-2000
AMANDA ANDERSEN
Internal Medicine
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 813-2000
TINA TRUONG
Dental Hygienist
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (800) 213-2000
SANDRA MEACHAM REED M.D.
Obstetrics & Gynecology
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 643-7565

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 Sally Kordab's NPI number?

The NPI number for Sally Kordab is 1710628292. It was assigned to this individual provider in the NPPES registry on April 6, 2022.

Where is Sally Kordab located?

Sally Kordab practices at 4855 SW Western Ave, Beaverton, OR 97005. The listed phone number is (800) 813-2000.

What is Sally Kordab's specialty?

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

Is Sally Kordab enrolled in Medicare?

Yes. Sally Kordab is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Sally Kordab's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sally Kordab reassigns Medicare benefits to Beaverton Rehab & Specialty Care, LLC (Beaverton, 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 Sally Kordab's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sally Kordab accept?

Health plans from Blue Cross and Blue Shield of Texas and Harbor Health list Sally Kordab 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 Sally Kordab was last updated on September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 48 days 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.