Individual provider Active NPI

Erika Elizabeth Schettler Huberty, MD

  • Otolaryngology Physician
  • Lake Oswego, OR
National Provider Identifier
1508963125
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD26956 Issued in OR
Practice address
17704 Jean Way
Suite 101
Lake Oswego, OR 97035
Phone
(503) 699-0370
Fax
(971) 236-9099
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD26956 OR Primary

Addresses

Primary practice location

17704 Jean Way
Suite 101
Lake Oswego, OR 97035

Mailing address

17704 Jean Way
Suite 101
Lake Oswego, OR 97035
Phone (503) 699-0370

Other identifiers 1

IdentifierTypeStateIssuer
028558MedicaidOR

Other names 1

  • Erika Elizabeth Schettler Former name

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
I20061107000205 OR Practitioner - Otolaryngology 5294769014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Southwestern Medical School at Dallas, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Grove ENT PCGroup PAC ID 9133135692, 5 clinicians

Practice addresses (Care Compare)

17704 Jean Way
Suite 101
Lake Oswego, OR 97035-5584
Phone (503) 635-0897

Hospital & facility affiliations

  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Grove ENT PC Otolaryngology CurrentSince Jan 1, 2007 Accepting new patients
Entoffice.Org, PLLC PastSince Jan 1, 2007 Accepting new patients

Locations

17704 Jean Way
Ste 101
Lake Oswego, OR 97035
Phone (503) 635-0897

Interoperability endpoints

  • Direct secure messaging: eschettlerhuberty18116@direct.lhs.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1508963125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17704 JEAN WAY",
            "address_2": "SUITE 101",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "97035",
            "telephone_number": "503-699-0370",
            "fax_number": "971-236-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17704 JEAN WAY",
            "address_2": "SUITE 101",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "97035",
            "telephone_number": "503-699-0370",
            "fax_number": "971-236-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHETTLER HUBERTY",
        "first_name": "ERIKA",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD26956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028558",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIKA",
            "last_name": "SCHETTLER",
            "middle_name": "ELIZABETH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.