Individual provider Active NPI

Aneet Jyot Deo, M.D.

  • Nephrology Physician
  • Salem, OR
National Provider Identifier
1013107556
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
154172 Issued in OR
Practice address
875 Oak St SE Ste 5070
Salem, OR 97301-3998
Phone
(503) 561-8565
Fax
(503) 561-8560
NPI assigned
Jul 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 045543 CT
Nephrology Physician 207RN0300X 154172 OR Primary

Addresses

Primary practice location

875 Oak St SE Ste 5070
Salem, OR 97301-3998

Mailing address

875 Oak St SE Ste 5070
Salem, OR 97301-3998
Phone (503) 561-8565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110829000694 OR Practitioner - Internal MedicinePractitioner - Nephrology 2466622592 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

19300 SW 65TH Ave
Meridian Park Hosp
Portland, OR 97062-7706
Phone (503) 692-1212

Hospital & facility affiliations

  • Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
045543CTMDInternal Medicine Physician
154172ORMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vibra Physicians LLC CurrentSince Dec 1, 2021 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Apr 13, 2023 Accepting new patients
Salem Health CurrentSince Jan 1, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine Current Accepting new patients
Salem Health CurrentSince Jan 1, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine CurrentSince Dec 3, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 3, 2019 Accepting new patients
Kidney Care Physicians LLC Nephrology CurrentSince Jul 1, 2011 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

10300 NE Hancock St
Portland, OR 97220
Phone (503) 257-5500

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

4805 NE Glisan St
Ste BG5
Portland, OR 97213
Phone (503) 215-2392

9205 SW Barnes Rd
Fl 1
Portland, OR 97225
Phone (503) 216-0790

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

875 Oak St SE
Ste 5070
Salem, OR 97301
Phone (503) 561-8564

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1013107556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE STE 5070",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013998",
            "telephone_number": "503-561-8565",
            "fax_number": "503-561-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE STE 5070",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013998",
            "telephone_number": "503-561-8565",
            "fax_number": "503-561-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEO",
        "first_name": "ANEET",
        "middle_name": "JYOT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "045543",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OR",
            "license": "154172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.