NPIMap

Organization Active NPI

Lester Tengsico LLC

Doing business as Division Foot Clinic

  • Podiatrist
  • Portland, OR
National Provider Identifier
1992942064
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DP00263 Issued in OR
Legal business name
LESTER TENGSICO LLC
Doing business as
Division Foot Clinic
Practice address
10424 SE Cherry Blossom Dr Ste F
Portland, OR 97216-2825
Phone
(503) 760-5151
Fax
(503) 760-5454
NPI assigned
Jan 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Authorized official

Name
Lester TengsicoNPI 1538124904
Title
Owner
Phone
(503) 760-5151

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X DP00263 OR Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X DP00263 OR
Foot Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0131X DP00263 OR

Addresses

Primary practice location

10424 SE Cherry Blossom Dr Ste F
Portland, OR 97216-2825

Mailing address

PO Box 33912
Portland, OR 97292-3912
Phone (503) 760-5151

Other names 1

  • Division Foot Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160201001875 OR Part B Supplier - Clinic/Group Practice 7416012455 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

10330 SE 32nd Ave
Ste 110
Portland, OR 97222
Phone (503) 513-1300

10424 SE Cherry Blossom Dr
Ste F
Portland, OR 97216
Phone (503) 459-1858

1350 Meridian Dr
Woodburn, OR 97071
Phone (503) 760-5151

Practitioners & affiliated clinicians

Practitioners 3

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": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1992942064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33912",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972923912",
            "telephone_number": "503-760-5151",
            "fax_number": "503-760-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10424 SE CHERRY BLOSSOM DR STE F",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162825",
            "telephone_number": "503-760-5151",
            "fax_number": "503-760-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESTER TENGSICO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "TENGSICO",
        "authorized_official_first_name": "LESTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-760-5151"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP00263",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OR",
            "license": "DP00263",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "OR",
            "license": "DP00263",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Division Foot Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 12, 2009; 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.