Lucas Eberhardt de Master, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2589 Issued in OR

Practice address

10201 SE Main St Ste 29
Portland, OR 97216-2937

Phone

(503) 740-1971

Fax

(503) 771-2436

NPI assigned

Sep 7, 2013

Last updated

Dec 20, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: leberhardtdemaster2250372@oc.providencedirect.org

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.

• Lucas Eberhardt de Master, PSYD, LLC

  • Clinical Psychologist
  • Portland, OR
  • NPI 1124538293

  WA

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1378512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1356776447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10117 SE SUNNYSIDE RD # F1217",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970157708",
            "telephone_number": "503-740-1971",
            "fax_number": "503-771-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 SE MAIN ST STE 29",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162937",
            "telephone_number": "503-740-1971",
            "fax_number": "503-771-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERHARDT DE MASTER",
        "first_name": "LUCAS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-07",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Eave, PHD, LPC
• David Ebaugh, LCSW
• Ebensteiner Chiropractic LLC
• Paul Ebensteiner, DC
• Joy Elizabeth Eberhardt de Master, M.D.
• Alice Eberharter, CCC-SLP
• Mary C Eberle, LCSW
• Lori Eberly, LCSW
• Allison Ebert
• Ginger Elizabeth Ebert, MOTR/L

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.