Individual provider Active NPI

Dario J Lapoma, PMHNP-DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1215536602
Registry record updated Dec 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10014568 Issued in OR
Practice address
2006 SE Ankeny St
Portland, OR 97214-1622
Phone
(503) 298-9165
Fax
(949) 695-3794
NPI assigned
Oct 18, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 10014568 OR Primary

Addresses

Primary practice location

2006 SE Ankeny St
Portland, OR 97214-1622

Mailing address

2006 SE Ankeny St
Portland, OR 97214-1622
Phone (503) 298-9165

Other practice location 1

2051 Kaen Rd
Oregon City, OR 97045-4035
Phone (503) 655-8581

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231018003550 OR Practitioner - Nurse Practitioner 0547615015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

150 Beavercreek Rd
Oregon City, OR 97045-4302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10014568ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clackamas County Single Specialty Current Accepting new patients
County of Clackamas Office of County Auditor CurrentSince Oct 2, 2023 Accepting new patients

Locations

2051 Kaen Rd
Ste 367
Oregon City, OR 97045
Phone (503) 742-5300

6605 SE Lake Rd
Portland, OR 97222
Phone (503) 665-8471

39740 Pleasant St
Sandy, OR 97055
Phone (503) 563-7679

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": "1602979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701561600000",
    "number": "1215536602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 SE ANKENY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141622",
            "telephone_number": "503-298-9165",
            "fax_number": "949-695-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 SE ANKENY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141622",
            "telephone_number": "503-298-9165",
            "fax_number": "949-695-3794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2051 Kaen Rd",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970454035",
            "country_code": "US",
            "telephone_number": "503-655-8581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAPOMA",
        "first_name": "DARIO",
        "middle_name": "J",
        "credential": "PMHNP-DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-18",
        "last_updated": "2023-12-03",
        "certification_date": "2023-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10014568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.