NPIMap

Organization Active NPI

PNW Plastic Surgery LLC

  • Plastic Surgery Physician
  • Keizer, OR
National Provider Identifier
1063185478
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PNW PLASTIC SURGERY LLC
Practice address
5305 River Rd N Ste B
Keizer, OR 97303-5324
Phone
(503) 749-5512
NPI assigned
Jul 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leo J Urbinelli, MD
Title
Owner
Phone
(503) 749-5512

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

5305 River Rd N Ste B
Keizer, OR 97303-5324

Mailing address

5305 River Rd N Ste B
Keizer, OR 97303-5324
Phone (503) 749-5512

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1063185478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 RIVER RD N STE B",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973035324",
            "telephone_number": "503-749-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 RIVER RD N STE B",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973035324",
            "telephone_number": "503-749-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PNW PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "URBINELLI",
        "authorized_official_first_name": "LEO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-749-5512",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keizer, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.