Edward Lawrence Rambousek, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO17804 Issued in OR

Practice address

381 NE Main St
Estacada, OR 97023-8529

Phone

(503) 630-4234

Fax

(503) 630-4234

NPI assigned

Nov 16, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Oak Grove Family Medical Clinic P C

  • Family Medicine Physician
  • Milwaukie, OR
  • NPI 1346218369
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801878707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "ESTACADA",
            "state": "OR",
            "postal_code": "970230640",
            "telephone_number": "503-630-4234",
            "fax_number": "503-630-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 NE MAIN ST",
            "city": "ESTACADA",
            "state": "OR",
            "postal_code": "970238529",
            "telephone_number": "503-630-4234",
            "fax_number": "503-630-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMBOUSEK",
        "first_name": "EDWARD",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO17804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051479",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oregon Massage & Lymphedema Clinic LLC
• Oregon Trail Chiropractic LLC
• Richard L Orth, DO
• Jared Robert Pettit
• Andrea Lea Premazzi, ND
• Jonathan Rhue, D.C.
• Justin Rye
• Kelly Joanne Salusova, MS, LPC
• Ivy Seaburg, NP
• Dana Rae Shibley, LDEM

• Family Medicine Physician in Estacada, OR
• Providers in Estacada, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.