Rsa - Portland, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

RSA - PORTLAND, LLC

Doing business as

U.S. Renal Care Portland Dialysis

Practice address

10595 SE Stark St
Portland, OR 97216-2747

Phone

(503) 252-0019

NPI assigned

Jan 8, 2008

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• U.S. Renal Care Portland Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

US Renal Care Inc

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382659200000",
    "number": "1629253711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WORLD TRADE CTR",
            "address_2": "STE 2500",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908310002",
            "telephone_number": "562-495-8075",
            "fax_number": "562-495-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10595 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162747",
            "telephone_number": "503-252-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RSA - PORTLAND, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2008-01-08",
        "last_updated": "2013-10-25",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218630",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Portland Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Joel Rozansky, MD
• Lindsay Alana Rozee Chandler
• Jennifer Christine Rozek, PA-C
• Boris M Rozenberg, DO
• Noa Rozenberg
• RSL Portland, LLC (Laurelhurst Village Rehabilitation Center)
• RTHM Medical Group of California, P.C.
• RTHM Medical Group, P.a. (RTHM Medical Group)
• Amber Clarissa Rubalcava
• Robert Rubenstein, LCSW

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.