NPIMap

Individual provider Active NPI

Luke Tegeler

  • Family Medicine Physician
  • Corvallis, OR
National Provider Identifier
1790226579
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO216415 Issued in OR
Practice address
3517 NW Samaritan Dr Ste 201
Corvallis, OR 97330-3769
Phone
(541) 768-5142
NPI assigned
Mar 14, 2017
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X PG205495 OR
Family Medicine Physician 207Q00000X DO216415 OR Primary

Addresses

Primary practice location

3517 NW Samaritan Dr Ste 201
Corvallis, OR 97330-3769

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

200 Mullins Dr
Lebanon, OR 97355-3983
Phone (541) 259-0200

Other practice location 2

1675 Leahy St Ste 315A
Muskegon, MI 49442-5543
Phone (231) 728-1751

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ltegeler207487@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240718002549 OR Practitioner - Family Practice 9537561113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Col of Osteo Med of the Pacific at Lebanon, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Hospital CorvallisGroup PAC ID 1557270725, 372 clinicians

Practice addresses (Care Compare)

3517 NW Samaritan Dr
Suite 201
Corvallis, OR 97330-3769
Phone (541) 768-5142

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
85.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO216415ORMDFamily Medicine Physician
PG205495ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santiam Memorial Hospital Current Accepting new patients
Good Samaritan Hospital Corvallis Family Medicine CurrentSince Jul 25, 2024 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Jul 25, 2024 Accepting new patients
Santiam Memorial Hospital CurrentSince Jul 26, 2024 Accepting new patients
Santiam Memorial Hospital CurrentSince Jul 26, 2024 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients
Western University of Health Sciences Past Accepting new patients

Locations

3517 NW Samaritan Dr
Ste 201
Corvallis, OR 97330
Phone (541) 768-5142

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

1375 N 10th Ave
Ste B
Stayton, OR 97383
Phone (503) 769-7546

1401 N 10th Ave
Stayton, OR 97383
Phone (503) 769-2175

Interoperability endpoints

  • Direct secure messaging: ltegeler207487@samhealth.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 53

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1790226579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3517 NW SAMARITAN DR STE 201",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303769",
            "telephone_number": "541-768-5142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Mullins Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973553983",
            "country_code": "US",
            "telephone_number": "541-259-0200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1675 Leahy St Ste 315A",
            "address_purpose": "LOCATION",
            "city": "Muskegon",
            "state": "MI",
            "postal_code": "494425543",
            "country_code": "US",
            "telephone_number": "231-728-1751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEGELER",
        "first_name": "LUKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-14",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "PG205495",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO216415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ltegeler207487@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3517 NW Samaritan Dr Ste 201",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.