EDWARD THEODORE YSUNZA IV
NPI 1083904015
Podiatrist - Foot & Ankle Surgery in Portland, OR
About Edward Theodore Ysunza Iv NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EDWARD THEODORE YSUNZA IV (NPI 1083904015) is an individual foot & ankle surgery provider in Portland, Oregon, licensed in Oregon (DP170018) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Edward Theodore Ysunza Iv is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Edward Ysunza reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Portland, OR 97210
- Reassigned Medicare billing, Oregon enrollment
- 387 clinicians in this Medicare group
Portland, OR 97232
- Reassigned Medicare billing, Oregon enrollment
- 719 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Edward Ysunza's NPI number?
The NPI number for Edward Ysunza is 1083904015. It was assigned to this individual provider in the NPPES registry on April 11, 2011.
Where is Edward Ysunza located?
Edward Ysunza practices at 3710 SW Us Veterans Hospital Rd, Portland, OR 97239. The listed phone number is (503) 220-8262.
What is Edward Ysunza's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.
Is Edward Ysunza enrolled in Medicare?
Yes. Edward Ysunza is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Edward Ysunza's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Edward Ysunza reassigns Medicare benefits to 2 organizations: Legacy Good Samaritan Hospital And Medical Center (Portland, OR) and Legacy Emanuel Hospital & Health Center (Portland, OR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Edward Ysunza's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Edward Ysunza was last updated on March 10, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Edward Theodore Ysunza IV · NPI 1083904015
Foot & Ankle Surgery provider in Portland, Oregon. Individual provider, active in the CMS NPPES registry since April 11, 2011.
## Identity
- **NPI:** 1083904015 (Entity type: Individual)
- **Enumerated:** April 11, 2011
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **State license:** DP170018 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 3710 SW US VETERANS HOSPITAL RD, Portland, OR 97239-2964
- **Phone:** (503) 220-8262
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Legacy Good Samaritan Hospital And Medical Center (NPI 1780608216, Portland, OR); Legacy Emanuel Hospital & Health Center (NPI 1003367491, Portland, OR) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 10, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1083904015) · Data from the CMS NPPES public registry.