Individual provider Active NPI

Paul Ebensteiner, DC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1669875282
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5583 Issued in OR
Practice address
5424 SE 82ND Ave
Portland, OR 97266-4811
Phone
(503) 477-8720
Fax
(503) 746-5328
NPI assigned
Sep 28, 2014
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5583 OR Primary

Addresses

Primary practice location

5424 SE 82ND Ave
Portland, OR 97266-4811

Mailing address

5424 SE 82ND Ave
Portland, OR 97266-4811
Phone (503) 477-8720

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

State licenses

LicenseStateTypeSpecialty
5583ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Trail Integrative Care, LLC PastSince Apr 23, 2023 Accepting new patients
Oregon Trail Chiropractic LLC Chiropractor PastSince May 1, 2015 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1411862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1669875282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5424 SE 82ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972664811",
            "telephone_number": "503-477-8720",
            "fax_number": "503-746-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 SE 82ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972664811",
            "telephone_number": "503-477-8720",
            "fax_number": "503-746-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBENSTEINER",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-28",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5583",
            "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 Apr 3, 2024; 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.