NORTHWEST EXTREMITY SPECIALISTS LLC – Podiatrist, NPI 1295126241
Podiatrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for NORTHWEST EXTREMITY SPECIALISTS LLC
6542 SE Lake Rd Ste 102
Milwaukie, OR 972222245
Phone: (503) 659-6686
Fax: (503) 905-6202
Type: Location
5050 NE Hoyt St Ste 411
Portland, OR 972132983
Phone: (503) 643-1737
Fax: (503) 643-4926
Type: Location
12658 SE Stark St Bldg H
Portland, OR 972331058
Phone: (503) 221-1581
Fax: (503) 221-1582
Type: Location
12400 NW Cornell Rd Ste 201
Portland, OR 972295689
Phone: (503) 643-1737
Fax: (503) 643-4926
Type: Location
18040 SW Lower Boones Ferry Rd Ste 207
Tigard, OR 972247259
Phone: (503) 245-2420
Fax: (503) 245-2445
Type: Location
9900 SW HALL BVLD
SUITE 100
TIGARD, OR 972235843
Phone: (503) 245-2420
Type: Mailing
5499 Amy St
West Linn, OR 970683320
Phone: (503) 655-0775
Fax: (503) 655-0751
Type: Location
10690 NE Cornell Rd Ste 212
Hillsboro, OR 971249224
Phone: (503) 245-2420
Fax: (503) 245-2445
Type: Location
16770 SW Edy Rd Ste 318
Sherwood, OR 971409678
Phone: (503) 245-2420
Fax: (503) 245-2445
Type: Location
2222 NW Lovejoy St Ste 510
Portland, OR 972105103
Phone: (503) 221-1581
Fax: (503) 221-1582
Type: Location
201 N Washington St
Newberg, OR 971322727
Phone: (503) 538-0800
Fax: (503) 554-8408
Type: Location
1000 N Providence Dr Ste 320
Newberg, OR 971327582
Phone: (503) 245-2420
Fax: (503) 245-2445
Type: Location
9115 SW OLESON RD STE 205
PORTLAND, OR 972236877
Phone: (503) 245-2420
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-02-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-03-31 (800 days ago).
Enrollment records
2
Earliest due date
2024-03-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20150420000860 | O | Clinic/Group Practice | OR | TBD |
| O20210219000602 | O | Physician - Podiatry | OR | 2024-03-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97222)
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