Portland Foot and Ankle Institute, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

DP00371 Issued in OR

Legal business name

PORTLAND FOOT AND ANKLE INSTITUTE, LLC

Practice address

12672 NW Barnes Rd Ste 100
Portland, OR 97229-6191

Phone

(503) 336-0169

Fax

(503) 352-4583

NPI assigned

Aug 13, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Michael Albert Gentile, DPM

Title

President

Phone

(503) 536-3074

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564444800000",
    "number": "1124507827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10690 NE CORNELL RD STE 212",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971249224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12672 NW BARNES RD STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972296191",
            "telephone_number": "503-336-0169",
            "fax_number": "503-352-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND FOOT AND ANKLE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-13",
        "last_updated": "2019-07-30",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-536-3074",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OR",
            "license": "DP00371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portland Eye Clinic LLC
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• Portland Family Practice Inc.
• Portland Family Services LLC
• Portland Foot and Ankle, LLC
• Portland Gastroenterology Equipment
• Portland Gynecologic Oncology, PC
• Portland Headache & Facial Pain LLC
• Portland Healing Space LLC

• Foot & Ankle Surgery Podiatrist in Portland, OR
• Providers in Portland, OR by specialty
• Foot & Ankle Surgery Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.