Organization Active NPI

The Doctors Luce Pediatrics, LLC

  • Primary Care Clinic/Center
  • Beaverton, OR
National Provider Identifier
1790015485
Registry record updated Jan 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
THE DOCTORS LUCE PEDIATRICS, LLC
Practice address
16280 NW Bethany CT
Beaverton, OR 97006-4885
Phone
(503) 713-5330
Fax
(503) 713-5330
NPI assigned
Jan 3, 2010
Last updated
Jan 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2010

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

Authorized official

Name
Dr. Mari Suto Luce, MDNPI 1235211004
Title
Member/President/Pediatrician
Phone
(503) 713-5330

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
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

16280 NW Bethany CT
Beaverton, OR 97006-4885

Mailing address

20229 SW Tremont Way
Beaverton, OR 97007-8594
Phone (503) 718-7802

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210401001461 OR Part B Supplier - Mass Immunization (Roster Biller Only) 0840607172 Practice locations: Beaverton, OR

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2166492Doctors Luce Pediatrics, LLC, the16280 NW Bethany Court, Beaverton, OR 97006Certificate of waiverMay 19, 2027

National Provider Directory

National Provider Directory

Locations

16280 NW Bethany Ct
Beaverton, OR 97006
Phone (503) 713-5330

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1262476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262476800000",
    "number": "1790015485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20229 SW TREMONT WAY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970078594",
            "telephone_number": "503-718-7802",
            "fax_number": "503-718-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16280 NW BETHANY CT",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064885",
            "telephone_number": "503-713-5330",
            "fax_number": "503-713-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DOCTORS LUCE PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-03",
        "last_updated": "2010-01-03",
        "status": "A",
        "authorized_official_last_name": "LUCE",
        "authorized_official_first_name": "MARI",
        "authorized_official_middle_name": "SUTO",
        "authorized_official_title_or_position": "MEMBER/PRESIDENT/PEDIATRICIAN",
        "authorized_official_telephone_number": "503-713-5330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2010; 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.