Individual provider Active NPI

Jerome J Dasilva, MD

  • Orthopaedic Surgery Physician
  • Vancouver, WA
National Provider Identifier
1043433774
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD60005618 Issued in WA
Practice address
200 NE Mother Joseph Place
Suite 110
Vancouver, WA 98664
Phone
(360) 254-6161
Fax
(360) 449-1139
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036117745 IL
Orthopaedic Surgery Physician 207X00000X MD60005618 WA Primary

Addresses

Primary practice location

200 NE Mother Joseph Place
Suite 110
Vancouver, WA 98664

Mailing address

200 NE Mother Joseph Place
Suite 210
Vancouver, WA 98664
Phone (360) 254-6161

Other identifiers 1

IdentifierTypeStateIssuer
8516940MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080919000002 WA Practitioner - Orthopedic Surgery 4385737923 Reassigns benefits to 1 organization
I20081023000845 OR Practitioner - Orthopedic Surgery 4385737923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwest Surgical Specialists PCGroup PAC ID 4183527153, 118 clinicians

Practice addresses (Care Compare)

1 N Ctr Court St
110 Rebound Sports Medicine
Portland, OR 97227-2104
Phone (503) 732-6863

200 NE Mother Joseph PL
110 Rebound Orthopedics
Vancouver, WA 98664-3293
Phone (360) 254-6161

200 NE Mother Joseph PL
Suite 210
Vancouver, WA 98664-3295

2121 NE 139TH St
300 Rebound
Vancouver, WA 98686-2316
Phone (360) 254-6161

2211 NE 139TH St
Legacy Salmon Creek Medical Center
Vancouver, WA 98686-2742
Phone (360) 487-1000

400 NE Mother Joseph PL
Peacehealth Southwest Medical Center
Vancouver, WA 98664-3200
Phone (360) 514-2000

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050
  • Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement44
Lower limb (leg) arthroscopy (minimally invasive joint repair)11
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60005618WAMDOrthopaedic Surgery Physician
036117745ILMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Surgical Specialists PC CurrentSince Oct 1, 2008 Accepting new patients
Northwest Surgical Specialists, P.C. Orthopaedic Surgery CurrentSince Oct 1, 2008 Accepting new patients
Midwest Orthopaedics at Rush, LLC Orthopaedic Surgery Past Accepting new patients
J and D Physical Therapy Services Past Accepting new patients

Locations

1 N Center Court St
Ste 110
Portland, OR 97227
Phone (503) 732-6863

1 N Center Court St
Ste 11
Portland, OR 97227
Phone (503) 732-6863

200 NE Mother Joseph Pl
Ste 110
Vancouver, WA 98664
Phone (360) 256-8584

200 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2990

3205 SE 192nd Ave
Ste 105
Vancouver, WA 98683

2121 NE 139th St
Ste 300
Vancouver, WA 98686

200 NE Mother Joseph Pl
Ste 210
Vancouver, WA 98664
Phone (360) 449-1145

200 NE Mother Joseph Pl
Ste 305
Vancouver, WA 98664

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

  • Direct secure messaging: jerome.dasilva.p1@direct.reboundmd.nextgenshare.com
  • Direct secure messaging: jdasilva21856@reboundmd.gardenplot.direct-ci.com

Organizations & group practices 4

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 4

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1043433774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PLACE",
            "address_2": "SUITE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98664",
            "telephone_number": "360-254-6161",
            "fax_number": "360-449-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PLACE",
            "address_2": "SUITE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98664",
            "telephone_number": "360-254-6161",
            "fax_number": "360-449-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASILVA",
        "first_name": "JEROME",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036117745",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD60005618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8516940",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.