Active NPI
Daniel Antonio Lujan, D.C.
- Chiropractor
- Portland, OR
National Provider Identifier
1003132408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4013
- Practice address
- 4425 SW Corbett Ave
Portland, OR 97239-4260 - Phone
- (503) 225-9033
- Fax
- (503) 225-9039
- NPI assigned
- Apr 12, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4013 | OR | Primary |
| Neurology Chiropractor | 111NN0400X | 4013 | OR | |
| Nutrition Chiropractor | 111NN1001X | 4013 | OR | |
| Pediatric Chiropractor | 111NP0017X | 4013 | OR | |
| Radiology Chiropractor | 111NR0200X | 4013 | OR | |
| Rehabilitation Chiropractor | 111NR0400X | 4013 | OR | |
| Sports Physician Chiropractor | 111NS0005X | 4013 | OR | |
| Orthopedic Chiropractor | 111NX0800X | 4013 | OR |
Addresses
Primary practice location
4425 SW Corbett Ave
Portland, OR 97239-4260
Mailing address
4425 SW Corbett Ave
Portland, OR 97239-4260
Phone (503) 225-9033
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2010
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
19300 SW Boones Ferry Rd
Suite 12
Tualatin, OR 97062-9062
Phone (503) 692-6568
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4013 | OR | MD | Nutrition Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tree City Chiropractic P.C. | Rehabilitation | Current | Accepting new patients |
Locations
19300 SW Boones Ferry Rd
Ste 12
Tualatin, OR 97062
Phone (503) 692-6568
Networks
- WA PPO C-SNP
- devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Chiropractor
- Tualatin, OR
- NPI 1700160025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271030400000",
"number": "1003132408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4425 SW CORBETT AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394260",
"telephone_number": "503-225-9033",
"fax_number": "503-225-9039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4425 SW CORBETT AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394260",
"telephone_number": "503-225-9033",
"fax_number": "503-225-9039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUJAN",
"first_name": "DANIEL",
"middle_name": "ANTONIO",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-12",
"last_updated": "2010-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "4013",
"primary": true
},
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "OR",
"license": "4013",
"primary": false
},
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "OR",
"license": "4013",
"primary": false
},
{
"code": "111NP0017X",
"taxonomy_group": "",
"desc": "Chiropractor, Pediatric Chiropractor",
"state": "OR",
"license": "4013",
"primary": false
},
{
"code": "111NR0200X",
"taxonomy_group": "",
"desc": "Chiropractor, Radiology",
"state": "OR",
"license": "4013",
"primary": false
},
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "OR",
"license": "4013",
"primary": false
},
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "OR",
"license": "4013",
"primary": false
},
{
"code": "111NX0800X",
"taxonomy_group": "",
"desc": "Chiropractor, Orthopedic",
"state": "OR",
"license": "4013",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.