Active NPI
Gary L Sultany, MD
- Rheumatology Physician
- Portland, OR
National Provider Identifier
1053411660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- MD13316
- Practice address
- 9155 SW Barnes Rd Ste 314
Portland, OR 97225-6630 - Phone
- (503) 297-3384
- Fax
- (503) 297-0863
- NPI assigned
- Sep 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | MD13316 | OR | Primary |
Addresses
Primary practice location
9155 SW Barnes Rd Ste 314
Portland, OR 97225-6630
Mailing address
9155 SW Barnes Rd Ste 314
Portland, OR 97225-6630
Phone (503) 297-3384
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 267799 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD13316 | OR | MD | Rheumatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340150400000",
"number": "1053411660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9155 SW BARNES RD STE 314",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256630",
"telephone_number": "503-297-3384",
"fax_number": "503-297-0863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9155 SW BARNES RD STE 314",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256630",
"telephone_number": "503-297-3384",
"fax_number": "503-297-0863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULTANY",
"first_name": "GARY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-24",
"last_updated": "2012-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "OR",
"license": "MD13316",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "267799",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.