NPIMap

Salem Gastroenterology Consultants, PC

Organization Active NPI Gastroenterology Physician · Salem, OR

NPI 1275634792 · NPPES record last updated Nov 13, 2024

Key facts

NPI
1275634792
Entity type
Organization (NPI type 2)
Primary specialty
Gastroenterology Physician 207RG0100X
Legal business name
SALEM GASTROENTEROLOGY CONSULTANTS, PC
Practice address
875 Oak St SE
Suite 3010
Salem, OR 97301-3975
Phone
(503) 399-7520
Fax
(503) 362-7344
NPI assigned
Sep 26, 2006
Organization subpart
No

Authorized official

Name
Dr. Nabil Choueiri, MD NPI 1124220660
Title
President
Phone
(503) 561-4043

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 22

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D0625641Salem Gastroenterology Consultants PC
875 Oak St SE Suite 3010, Salem, OR 97301		Certificate of waiverDec 31, 2027
38D2030331Salem Gastroenterology Consultants
875 Oak St SE, Suite 3010, Salem, OR 97301		ComplianceDec 27, 2027
38D2313023Salem Gastroenterology Consultants, PC
4747 Skyline Rd S, Salem, OR 97306		Certificate of waiverOct 22, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040429000061 OR Part B Supplier - Clinic/Group Practice 4183611361 Receives reassigned benefits from 19 practitioners
Practice locations: Salem, OR

National Provider Directory

Locations

4747 Skyline Rd S
Ste 100
Salem, OR 97306
Phone (503) 399-7520

875 Oak St SE
Ste 3010
Salem, OR 97301
Phone (503) 399-7520

1467 13th St SE
Salem, OR 97302
Phone (503) 399-7520

875 Oak St SE
Ste C3010
Salem, OR 97301
Phone (503) 399-7520

875 Oak St SE
Ste 3090
Salem, OR 97301
Phone (503) 561-8550

870 Oak St SE Ste 3010 BLG C
Salem, OR 97301

4747 Skyline Rd S
Salem, OR 97306
Phone (503) 399-7520

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207RG0100X OR Yes

Addresses

Primary practice location

875 Oak St SE
Suite 3010
Salem, OR 97301-3975

Mailing address

875 Oak St SE
Suite 3010
Salem, OR 97301-3975
Phone (503) 399-7520

Other practice location 1

4747 Skyline Rd S
Salem, OR 97306-4200
Phone (503) 399-7520

Other identifiers

IdentifierTypeStateIssuer
027980MedicaidOR

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 13, 2024.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1275634792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE",
            "address_2": "SUITE 3010",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013975",
            "telephone_number": "503-399-7520",
            "fax_number": "503-362-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE",
            "address_2": "SUITE 3010",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013975",
            "telephone_number": "503-399-7520",
            "fax_number": "503-362-7344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4747 Skyline Rd S",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973064200",
            "country_code": "US",
            "telephone_number": "503-399-7520",
            "fax_number": "503-362-7344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SALEM GASTROENTEROLOGY CONSULTANTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "CHOUEIRI",
        "authorized_official_first_name": "NABIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-561-4043",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027980",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

All providers in Salem, OR · Gastroenterology Physician in Oregon

Sources for this page

Verify at the official NPI Registry.