Individual provider Active NPI

Lyle R Torguson, MD

  • Family Medicine Physician
  • Pleasant Hill, OR
National Provider Identifier
1649248139
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD25885 Issued in OR
Practice address
35859 Highway 58
Pleasant Hill, OR 97455-9651
Phone
(541) 640-7625
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD25885 OR Primary

Addresses

Primary practice location

35859 Highway 58
Pleasant Hill, OR 97455-9651

Mailing address

1292 High St Ste 224
Eugene, OR 97401-3238
Phone (541) 500-2500

Other identifiers 1

IdentifierTypeStateIssuer
213527MedicaidOR

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
I20050907000796 OR Practitioner - Family Practice 0648202994 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32773MNMDSocial Worker
MD25885ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC Current Accepting new patients
Icco LLC CurrentSince Sep 1, 2016 Accepting new patients
Icco, LLC CurrentSince Sep 1, 2016 Accepting new patients

Locations

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

1292 High St
Eugene, OR 97401
Phone (541) 636-3473

35859 Highway 58
Pleasant Hill, OR 97455
Phone (541) 767-5200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1649248139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1292 HIGH ST STE 224",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013238",
            "telephone_number": "541-500-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35859 HIGHWAY 58",
            "city": "PLEASANT HILL",
            "state": "OR",
            "postal_code": "974559651",
            "telephone_number": "541-640-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORGUSON",
        "first_name": "LYLE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD25885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213527",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Hill, OR

Sources for this page

Verify at the official NPI Registry.