Mohan Avula, DO
Individual provider Active NPI Internal Medicine Physician · Corvallis, OR
NPI 1003605387 · NPPES record last updated May 3, 2025
Key facts
- NPI
- 1003605387
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- PG225502 (OR)
- Practice address
- 3600 NW Samaritan Dr
Corvallis, OR 97330-5472 - Phone
- (541) 768-4906
- NPI assigned
- May 3, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250715003363 | OR | Order and Referring Only - Internal Medicine |
4688189947 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Interoperability endpoints
- mavula322807@samhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | PG225502 | OR | Yes |
Addresses
Primary practice location
3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Mailing address
3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Phone (541) 768-4906
Other providers in Corvallis, OR
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- Susan Mae Avila
- Austin Robert Aviles
- Aaron P Avon
- Awakened Heart LLC
- Stephanie Anne Axman
- Myo Sabai Aye
- Leela Ayres
- Nesreen Aysheh
All providers in Corvallis, OR · Internal Medicine Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.