Lisa Marie Newton-Klucevek, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO21207 Issued in OR

Practice address

9450 SW Barnes Rd Ste 100
Portland, OR 97225-6642

Phone

(503) 292-9560

Fax

(503) 292-9510

NPI assigned

Oct 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1528155280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 SW HALL BLVD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-293-0161",
            "fax_number": "503-221-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9450 SW BARNES RD STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256642",
            "telephone_number": "503-292-9560",
            "fax_number": "503-292-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWTON-KLUCEVEK",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO21207",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "0021207",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287850",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Newport
• Brittaney Rachell Newsome, PA-C
• Eluid Newsome
• Newstart PMR Clinic, P.C.
• Sonya Marie Newstrom, CADC I/QMHA-I
• Adrienne Newton, DMD
• Carol Irene Newton
• Jonathan Newton
• Patricia Anne Newton, M.D.
• Ryan Patrick Newton, MA, MFA, QMHA

• Family Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.