Lakshmi C Aggarwal, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Portland, OR
NPI 1053547174 · NPPES record last updated Dec 22, 2021
Key facts
- NPI
- 1053547174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011 - Phone
- (503) 494-8211
- NPI assigned
- Jun 3, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Permanente Medical Group Inc
Practice addresses (Care Compare)
1800 Harrison St
FL 7
Oakland, CA 94612-3466
7373 W Lane
Stockton, CA 95210-3377
Phone (209) 476-2000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180122000518 | CA | Practitioner - Internal Medicine | 5496995144 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL18630 | OR | MD | Internal Medicine Physician |
| MD168582 | OR | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group Inc | Internal Medicine | Current |
Accepting new patients |
| Permanente Medical Group, Inc. | Past |
Accepting new patients | |
| The Permanente Medical Group, Inc. | Past |
Accepting new patients | |
| Kaiser Permanente | Past |
Accepting new patients | |
| The Permanente Medical Group | Past |
Accepting new patients | |
| The Permanente Medical Group | Past |
Accepting new patients |
Locations
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
401 Bicentennial Way
Santa Rosa, CA 95403
Phone (707) 393-4000
5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD168582 | OR | |
| Internal Medicine Physician | 207R00000X | LL18630 | OR | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Mailing address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8211
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Portland, OR
- Osaretine Agbonze
- Prince Roland Agbonze
- Leah Francine Agcaoili
- Travis Lee Agee
- Shaun Lowell Ageno
- Agger Chiropractic Clinic LLC
- Simon John Agger
- Kareem Aggour
- Kristy Merck Aghayan
- Aging Simplified LLC
All providers in Portland, OR · Student in an Organized Health Care Education/Training Program in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.