Corvallis Gastroenterology PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

CORVALLIS GASTROENTEROLOGY PC

Practice address

3521 NW Samaritan Dr
Suite 101
Corvallis, OR 97330-4744

Phone

(541) 768-6119

Fax

(541) 768-6120

NPI assigned

May 28, 2006

Organization subpart

No

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

Authorized official

Name

Surinder Mohan Vasdev, MDNPI 1093893554

Title

President

Phone

(541) 768-6116

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Surinder Ms Vasdev, MD

  • Gastroenterology Physician
  • Corvallis, OR
  • NPI 1093893554

  Specialist

  Medicare reassignment NPD Authorized official
• Anne Marie Breitinger, MD

  • Gastroenterology Physician
  • Milwaukie, OR
  • NPI 1871772442
  Medicare reassignment NPD
• Hsichao Chow, MD

  • Gastroenterology Physician
  • Corvallis, OR
  • NPI 1356431464
  Medicare reassignment NPD
• Ryan J De Lee, MD

  • Gastroenterology Physician
  • Springfield, OR
  • NPI 1104920693
  Medicare reassignment NPD
• Craig Randall Ferguson, ARNP

  • Family Nurse Practitioner
  • Bend, OR
  • NPI 1477717130
  Medicare reassignment NPD
• Keith E Harris, MD

  • Gastroenterology Physician
  • Corvallis, OR
  • NPI 1538235726
  Medicare reassignment NPD
• Jonathan Hattenhauer, D.O.

  • Gastroenterology Physician
  • Milwaukie, OR
  • NPI 1013302348
  Medicare reassignment NPD
• Chad Aaron Morse, M.D.

  • Gastroenterology Physician
  • Corvallis, OR
  • NPI 1588794135
  Medicare reassignment NPD
• Gregory David Schwartz, MD

  • Specialist
  • Corvallis, OR
  • NPI 1760423289
  Medicare reassignment NPD
• Matthew Walton, M.D.

  • Gastroenterology Physician
  • Corvallis, OR
  • NPI 1952497737
  Medicare reassignment NPD
• Gail Pearson, NP

  • Primary Care Nurse Practitioner
  • Bellevue, WA
  • NPI 1164551214

  OR

  Medicare reassignment NPD
• Michelle Patrice Wolf, ARNP

  • Family Nurse Practitioner
  • Tacoma, WA
  • NPI 1841921277

  OR

  Medicare reassignment NPD

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1124075627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 NW SAMARITAN DR",
            "address_2": "SUITE 101",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304744",
            "telephone_number": "541-768-6119",
            "fax_number": "541-768-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 NW SAMARITAN DR",
            "address_2": "SUITE 101",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304744",
            "telephone_number": "541-768-6119",
            "fax_number": "541-768-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORVALLIS GASTROENTEROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "VASDEV",
        "authorized_official_first_name": "SURINDER",
        "authorized_official_middle_name": "MOHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-768-6116",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240038",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corvallis Daytime Drop-in Center
• Corvallis Dental Group Inc
• Corvallis Eye Care
• Corvallis Family Dentistry, LLC
• Corvallis Family Medicine PC
• Corvallis Homeless Shelter Coalition
• Corvallis Internal Medicine, PC
• Corvallis Medical Group LLC
• Corvallis MRI a Joint Venture
• Corvallis Natural Medicine, Inc

• Specialist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.