Individual provider Active NPI

Dominique D Laron, M.D.

  • Orthopaedic Surgery Physician
  • Portland, OR
National Provider Identifier
1164789079
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD195426 Issued in OR
Practice address
3101 SW Sam Jackson Park Rd
Portland, OR 97239-3009
Phone
(503) 221-3424
Fax
(503) 221-3490
NPI assigned
Apr 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X MD195426 OR
Orthopaedic Surgery Physician 207X00000X MD195426 OR Primary

Addresses

Primary practice location

3101 SW Sam Jackson Park Rd
Portland, OR 97239-3009

Mailing address

3101 Jackson Park Rd.
Portland, OR 97239
Phone (503) 215-6494

Other practice location 1

9155 SW Barnes Rd Ste 211
Portland, OR 97225-6629
Phone (503) 216-6050

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dlaron1152159@oc.providencedirect.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191104001766 OR Practitioner - Pediatric Medicine 9335432798 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129434CAMDMarriage & Family Therapist
MD195426ORMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Nov 1, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Nov 1, 2019 Accepting new patients
University Professional Services Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
University Professional Services CurrentSince Nov 1, 2019 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 1, 2019 Accepting new patients
University Professional Services CurrentSince Nov 1, 2019 Accepting new patients
Shriners Hospitals for Children Orthopaedic Surgery Past Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

9155 SW Barnes Rd
Ste 211
Portland, OR 97225
Phone (503) 292-7356

9135 SW Barnes Rd
Ste 763
Portland, OR 97225
Phone (503) 216-6050

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

Interoperability endpoints

  • Direct secure messaging: dlaron1152159@oc.providencedirect.org

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1164789079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 JACKSON PARK RD.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393009",
            "telephone_number": "503-221-3424",
            "fax_number": "503-221-3490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9155 SW Barnes Rd Ste 211",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256629",
            "country_code": "US",
            "telephone_number": "503-216-6050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARON",
        "first_name": "DOMINIQUE",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-16",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "OR",
            "license": "MD195426",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD195426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dlaron1152159@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9155 SW Barnes Rd Ste 211",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.