Lara Jae Gamelin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD19740 Issued in OR

Practice address

2400 NW Kings Blvd
Corvallis, OR 97330-3900

Phone

(541) 757-2400

Fax

(541) 752-0931

NPI assigned

Nov 9, 2006

Last updated

Aug 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Family Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Corvallis Clinic P CGroup PAC ID 1456244540, 128 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14349/brand/4/csg/42/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/GDACAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Corvallis Clinic P C

  • Multi-Specialty Clinic/Center
  • Corvallis, OR
  • NPI 1649227265
  Medicare reassignment Care Compare group NPD
• Corvallis Family Medicine PC

  • Family Medicine Physician
  • Corvallis, OR
  • NPI 1841228327
  Medicare reassignment
• The Corvallis Clinic P C

  • Urgent Care Clinic/Center
  • Corvallis, OR
  • NPI 1679362198
  NPD

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1144390592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 NW KINGS BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303900",
            "telephone_number": "541-757-2400",
            "fax_number": "541-752-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NW KINGS BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303900",
            "telephone_number": "541-757-2400",
            "fax_number": "541-752-0931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3680 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303737",
            "country_code": "US",
            "telephone_number": "541-754-1150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMELIN",
        "first_name": "LARA",
        "middle_name": "JAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD19740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX OR BUSINESS ID NUMBER",
            "identifier": "931288530",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078225",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Dawn Gallagher
• James C Gallagher, PT
• Matthew Brett Gallagher, M.S.
• James David Gallant, MD
• Marissa Alexandra Gallegos, THW DOULA
• Sergio Gamez
• Maria De la Luz Gamino
• Raianne Marie Gamma
• Hannah Rein Gantz
• Philip Gao

• Family Medicine Physician in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.