Individual provider Active NPI

Leslie E Schmertzler, M.D.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1609978436
Registry record updated Jul 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD12041 Issued in OR
Practice address
19500 SE Stark St
Portland, OR 97233-5757
Phone
(503) 669-3900
Fax
(503) 669-3998
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD12041 OR Primary
Internal Medicine Physician 207R00000X MD00034522 WA

Addresses

Primary practice location

19500 SE Stark St
Portland, OR 97233-5757

Mailing address

19500 SE Stark St
Portland, OR 97233-5757
Phone (503) 669-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD12041ORMDInternal Medicine Physician
MD00034522WAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184457600000",
    "number": "1609978436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19500 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335757",
            "telephone_number": "503-669-3900",
            "fax_number": "503-669-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335757",
            "telephone_number": "503-669-3900",
            "fax_number": "503-669-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMERTZLER",
        "first_name": "LESLIE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD12041",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00034522",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.