KENNETH ALAN ENSROTH MD
NPI 1770599185
Psychiatry & Neurology - Child & Adolescent Psychiatry in Oregon City, OR

Q: What is Kenneth Ensroth's NPI number?

The NPI number for Kenneth Ensroth is 1770599185. It was assigned to this individual provider in the NPPES registry on July 31, 2006.

Q: What is Kenneth Ensroth's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Ensroth was last updated on March 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since July 31, 2006PECOS EnrolledAccepts Medicare Assignment

1500 DIVISION ST, CHILD CLINIC, OREGON CITY, OR 97045(503) 722-3700(503) 722-3750 Get Directions Write a Review

NPPES record last updated: March 9, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kenneth Alan Ensroth Md NPPES

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

KENNETH ALAN ENSROTH MD (NPI 1770599185) is an individual child & adolescent psychiatry provider in Oregon City, Oregon, licensed in Oregon (MD22953) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Michigan State University College Of Human Medicine (1983).

NPPES Registry Identity

NPI1770599185

Entity TypeIndividualMale

Primary Taxonomy2084P0804X

Provider Legal NameKENNETH ALAN ENSROTHCredential: MD

Location Address1500 DIVISION ST, CHILD CLINICOregon City, OR 97045-1527

Mailing AddressPo Box 3158Portland, OR 97208-3158 · (503) 722-3700 · Fax (503) 722-3750

Phone(503) 722-3700

Fax(503) 722-3750

Sole ProprietorNo

Medical School CMSMichigan State University College Of Human MedicineGraduated 1983

Enumeration DateJuly 31, 2006

Last NPPES UpdateMarch 9, 2021

NPPES CertifiedMarch 9, 2021

✔ NPI 1770599185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

License✔ Licensed in OR · MD22953

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

1500 DIVISION ST, Oregon City, OR 97045

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Other Identifiers 2

Medicaid500656755OR

Medicaid287772OR

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kenneth Alan Ensroth Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8426246778

PECOS Enrollment IDI20101230000604

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 20

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

PROVIDENCE HEALTH & SERVICES - OREGON

Pathology (Clinical Pathology)