Individual provider Active NPI

Rae Louise Lantsberger, DPM

  • Podiatrist
  • Portland, OR
National Provider Identifier
1215153556
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DP00212 Issued in OR
Practice address
610 SW Alder
Suite 506
Portland, OR 97205
Phone
(503) 223-3380
Fax
(503) 223-2522
NPI assigned
Apr 17, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DP00212 OR Primary

Addresses

Primary practice location

610 SW Alder
Suite 506
Portland, OR 97205

Mailing address

610 SW Alder
Suite 506
Portland, OR 97205
Phone (503) 223-3380

Other identifiers 1

IdentifierTypeStateIssuer
046297MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121226000000 OR Practitioner - Podiatry 2062665060 Practice locations: Gresham, OR; Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2775 E Powell Valley Rd
Gresham, OR 97080-1475
Phone (503) 667-7789

610 SW Alder St
Suite 506
Portland, OR 97205-3606
Phone (503) 223-3380

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue325
Removal of skin lesions366
Removal of nail tissue151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Downtown Foot Clinic, LLC CurrentSince Apr 20, 2021 Accepting new patients

Locations

610 SW Alder St
Ste 506
Portland, OR 97205
Phone (503) 223-3380

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215153556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 SW ALDER",
            "address_2": "SUITE 506",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-223-3380",
            "fax_number": "503-223-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SW ALDER",
            "address_2": "SUITE 506",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-223-3380",
            "fax_number": "503-223-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANTSBERGER",
        "first_name": "RAE",
        "middle_name": "LOUISE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP00212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046297",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.