Bridge City Foot & Ankle LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

BRIDGE CITY FOOT & ANKLE LLC

Practice address

4770 SW Watson Ave
Beaverton, OR 97005-0511

Phone

(503) 427-8967

Fax

(971) 223-0096

NPI assigned

Nov 9, 2020

Last updated

Oct 18, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Peter Stach, DPMNPI 1366965675

Title

Owner/Podiatric Physician

Phone

(503) 805-4720

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR2 enrollments

Enrollment records 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter Stach, DPM

  • Podiatrist
  • Beaverton, OR
  • NPI 1366965675
  Medicare reassignment Care Compare group NPD Authorized official
• Michael James Weindorf, DPM

  • Podiatrist
  • Salem, OR
  • NPI 1356838825
  Medicare reassignment Care Compare group NPD
• Ameer Matariyeh

  • Podiatrist
  • Chicago, IL
  • NPI 1427544113

  OR

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1669074316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 SW HUNTINGTON AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972254752",
            "telephone_number": "503-805-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 SW WATSON AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970050511",
            "telephone_number": "503-427-8967",
            "fax_number": "971-223-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE CITY FOOT & ANKLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "STACH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER/PODIATRIC PHYSICIAN",
        "authorized_official_telephone_number": "503-805-4720",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Brewer, PSY. D.
• Susan Ann Brewer, CNM
• Thomas James Brewer, PSY.D.
• Brian M. Spangler DDS, PC
• Erin Bricker, M.S., CCC-SLP
• Bridge City Mental Wellness LLC
• Chelsey Kay Bridgeman, M.ED, BCBA, LBA
• Chelsey Nicole Bridges
• Bridgeway Oncology
• Brigette Keane Counseling, LLC

• Podiatrist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.