Individual provider Active NPI

Leslie Rae Pelinka, M.D.

  • Pediatrics Physician
  • Springfield, OR
National Provider Identifier
1275643645
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A83842 Issued in CA
Practice address
3377 Riverbend Dr
Springfield, OR 97477-8803
Phone
(541) 222-8500
Fax
(541) 222-6435
NPI assigned
Aug 30, 2006
Last updated
Jan 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A83842 CA Primary

Addresses

Primary practice location

3377 Riverbend Dr
Springfield, OR 97477-8803

Mailing address

3377 Riverbend Drive
Eugene, OR 97401-3568
Phone (541) 222-8500

Other identifiers 2

IdentifierTypeStateIssuer
00A838420MedicaidCA
274316MedicaidOR

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070621000325 OR Practitioner - Pediatric Medicine 3476523432 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A83842CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Medical Group Pediatrics CurrentSince Sep 26, 2016 Accepting new patients
Peacehealth CurrentSince Aug 1, 2016 Accepting new patients
Peacehealth Medical Group CurrentSince Sep 26, 2016 Accepting new patients
Peacehealth CurrentSince Aug 1, 2016 Accepting new patients
Peacehealth Past Accepting new patients
UCSF Pediatrics Associates Pediatrics Past Accepting new patients
Stanford Health Care Pediatrics Past Accepting new patients

Locations

4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300

390 9th St
Florence, OR 97439
Phone (541) 997-7134

400 9th St
Florence, OR 97439
Phone (541) 997-8412

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

Interoperability endpoints

  • Direct secure messaging: lpelinka2409@direct.peacehealth.org

Organizations & group practices 7

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1275643645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3377 RIVERBEND DRIVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013568",
            "telephone_number": "541-222-8500",
            "fax_number": "541-222-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3377 RIVERBEND DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778803",
            "telephone_number": "541-222-8500",
            "fax_number": "541-222-6435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELINKA",
        "first_name": "LESLIE",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A83842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A838420",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274316",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.