Individual provider Active NPI

Chersky Alejandro Lopez, CRM, PEER SPECIALIST

  • Peer Specialist
  • Portland, OR
National Provider Identifier
1619781630
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
22-CRM-1040 Issued in OR
Practice address
3231 SE 50TH Ave
Portland, OR 97206-2248
Phone
(503) 238-5203
NPI assigned
Feb 3, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 22-CRM-1040 OR Primary

Addresses

Primary practice location

3231 SE 50TH Ave
Portland, OR 97206-2248

Mailing address

3231 SE 50TH Ave
Portland, OR 97206-2248
Phone (503) 238-5203

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22-CRM-1040ORMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1619781630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 SE 50TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062248",
            "telephone_number": "503-238-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 SE 50TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062248",
            "telephone_number": "503-238-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "CHERSKY",
        "middle_name": "ALEJANDRO",
        "credential": "CRM, PEER SPECIALIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "22-CRM-1040",
            "primary": true
        }
    ],
    "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 Feb 3, 2025; 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.