Individual provider Active NPI

Michael Brown, D.O.

  • Family Medicine Physician
  • Salem, OR
National Provider Identifier
1245449099
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO28614 Issued in OR
Practice address
3777 Commercial St SE
Salem, OR 97302-3832
Phone
(503) 588-1234
Fax
(503) 371-8662
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X LL16276 OR
Family Medicine Physician 207Q00000X DO28614 OR Primary

Addresses

Primary practice location

3777 Commercial St SE
Salem, OR 97302-3832

Mailing address

3777 Commercial St SE
Salem, OR 97302-3832
Phone (503) 588-1234

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
I20090123000054 OR Practitioner - Family Practice 3274697016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem Clinic PCGroup PAC ID 7517954514, 96 clinicians

Practice addresses (Care Compare)

2020 Capitol St NE
Salem, OR 97301-0644
Phone (503) 399-2424

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL16276ORMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Clinic, PC General Practice CurrentSince Dec 19, 2013 Accepting new patients
Urgent Care Clinic South Past Accepting new patients
Firstcare Medical Foundation Family Medicine PastSince Sep 1, 2004 Accepting new patients
Good Samaritan Hospital Corvallis Past Accepting new patients

Locations

5900 Inland Shores Way N
Keizer, OR 97303
Phone (503) 485-4787

2531 Boone Rd SE
Salem, OR 97306
Phone (503) 399-2470

2020 Capitol St NE
Salem, OR 97301
Phone (503) 399-2470

Interoperability endpoints

  • Direct secure messaging: mbrown40559@salemclinic.gardenplot.direct-ci.com

Organizations & group practices 4

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1245449099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3777 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973023832",
            "telephone_number": "503-588-1234",
            "fax_number": "503-371-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3777 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973023832",
            "telephone_number": "503-588-1234",
            "fax_number": "503-371-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OR",
            "license": "LL16276",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO28614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.