Active NPI
Ci an Gerald Tay
- Otolaryngology Physician
- Portland, OR
National Provider Identifier
1104289933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- FE177229
- Practice address
- 3181 SW Sam Jackson Park Rd , PV01
Portland, OR 97239 - Phone
- (503) 494-8510
- NPI assigned
- Mar 30, 2016
- 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | FE177229 | OR | Primary |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd , PV01
Portland, OR 97239
Mailing address
3181 SW Sam Jackson Park Rd , PV01
Portland, OR 97239
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| FE177229 | OR | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459382400000",
"number": "1104289933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD , PV01",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD , PV01",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "503-494-8510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAY",
"first_name": "CI AN GERALD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-30",
"last_updated": "2016-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "OR",
"license": "FE177229",
"primary": true
}
],
"identifiers": [],
"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 Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.