Individual provider Active NPI

Jeffrey A Zelasko, D.C.

  • Chiropractor
  • Portland, OR
National Provider Identifier
1144755729
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5812 Issued in OR
Practice address
3942 SE Hawthorne Blvd
Portland, OR 97214-5242
Phone
(503) 235-5484
Fax
(503) 235-3956
NPI assigned
Apr 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5812 OR Primary

Addresses

Primary practice location

3942 SE Hawthorne Blvd
Portland, OR 97214-5242

Mailing address

16312 SE Heart PL
Milwaukie, OR 97267-5000
Phone (619) 743-5502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5812ORMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum Wellness and Performance Chiropractor Current Accepting new patients
Milwaukie Chiropractic Center Chiropractor PastSince Jan 1, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1144755729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16312 SE HEART PL",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972675000",
            "telephone_number": "619-743-5502",
            "fax_number": "503-235-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3942 SE HAWTHORNE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145242",
            "telephone_number": "503-235-5484",
            "fax_number": "503-235-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELASKO",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5812",
            "primary": true
        }
    ],
    "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 20, 2017; 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.