Active NPI
Rebecca Kate Neborsky, MD
- Family Medicine Physician
- Tigard, OR
National Provider Identifier
1831295161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD29317
- Practice address
- 18040 SW Lower Boones Ferry Rd
Suite 100
Tigard, OR 97224-7258 - Phone
- (503) 216-0700
- NPI assigned
- Sep 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ML20008600 | WA | |
| Family Medicine Physician | 207Q00000X | MD29317 | OR | Primary |
Addresses
Primary practice location
18040 SW Lower Boones Ferry Rd
Suite 100
Tigard, OR 97224-7258
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500611594 | Medicaid | OR | |
| P00774484 | Other | OR | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Previously, effective Sep 12, 2016 through Sep 12, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ML20008600 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lester M Baskin MD PC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343692800000",
"number": "1831295161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158",
"telephone_number": "503-215-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18040 SW LOWER BOONES FERRY RD",
"address_2": "SUITE 100",
"city": "TIGARD",
"state": "OR",
"postal_code": "972247258",
"telephone_number": "503-216-0700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEBORSKY",
"first_name": "REBECCA",
"middle_name": "KATE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-15",
"last_updated": "2012-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "ML20008600",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD29317",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500611594",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00774484",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.