TEAL CLOCKSIN MD
NPI 1780212621
Radiology - Diagnostic Radiology in Portland, OR
About Teal Clocksin Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TEAL CLOCKSIN MD (NPI 1780212621) is an individual diagnostic radiology provider in Portland, Oregon, licensed in Oregon (MD208407) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS and is a graduate of University Of New Mexico School Of Medicine (2020).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Teal Clocksin 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.
Medicare Billing Reassignment
Medicare enrollment records show Teal Clocksin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Portland, OR 97209
- Reassigned Medicare billing, Oregon and Washington enrollments
- Also billed through NPI 1871848457 (Washington)
- 3,207 clinicians in this Medicare group
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.
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.
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
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 Teal Clocksin's NPI number?
The NPI number for Teal Clocksin is 1780212621. It was assigned to this individual provider in the NPPES registry on March 27, 2020.
Where is Teal Clocksin located?
Teal Clocksin practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-8211.
What is Teal Clocksin's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.
Is Teal Clocksin enrolled in Medicare?
Yes. Teal Clocksin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Teal Clocksin's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Teal Clocksin 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 Teal Clocksin'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 Teal Clocksin was last updated on June 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.
# Teal Clocksin, MD · NPI 1780212621
Diagnostic Radiology physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since March 27, 2020.
## Identity
- **NPI:** 1780212621 (Entity type: Individual)
- **Enumerated:** March 27, 2020
- **Primary specialty:** Radiology - Diagnostic Radiology · taxonomy 2085R0202X
- **State license:** MD208407 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 3181 SW SAM JACKSON PARK RD, Portland, OR 97239-3011
- **Phone:** (503) 494-8211
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Kaiser Foundation Health Plan Of The Northwest (NPI 1649722034, Portland, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of New Mexico School Of Medicine, class of 2020
## Record status
- **NPPES last updated:** June 18, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1780212621) · Data from the CMS NPPES public registry.