Organization Active NPI

Surelux, LLC

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1669928578
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SURELUX, LLC
Practice address
2100 NE Broadway St
Suite 225
Portland, OR 97232-1569
Phone
(503) 719-5000
Fax
(971) 255-1754
NPI assigned
Aug 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Authorized official

Name
Christina Yogerst, DCNPI 1619051513
Title
Sole MBR
Phone
(503) 719-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2100 NE Broadway St
Suite 225
Portland, OR 97232-1569

Mailing address

2100 NE Broadway St
Suite 225
Portland, OR 97232-1569
Phone (503) 719-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161011003062 OR Part B Supplier - Clinic/Group Practice 7113215948 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

2326 NW Lovejoy St
Portland, OR 97210
Phone (503) 224-4804

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1669928578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NE BROADWAY ST",
            "address_2": "SUITE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321569",
            "telephone_number": "503-719-5000",
            "fax_number": "971-255-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NE BROADWAY ST",
            "address_2": "SUITE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321569",
            "telephone_number": "503-719-5000",
            "fax_number": "971-255-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURELUX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "YOGERST",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "503-719-5000",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "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 Oct 20, 2016; 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.