Individual provider Active NPI

David Gissen, M.D.

  • Anesthesiology Physician
  • Portland, OR
National Provider Identifier
1295749695
Registry record updated Nov 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD158172 Issued in OR
Practice address
2846 NW Ariel Ter
Portland, OR 97210-3119
Phone
(775) 883-2202
Fax
(775) 883-0797
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G54203 CA
Anesthesiology Physician 207L00000X 5549 NV
Anesthesiology Physician 207L00000X MD158172 OR Primary

Addresses

Primary practice location

2846 NW Ariel Ter
Portland, OR 97210-3119

Mailing address

2846 NW Ariel Ter
Portland, OR 97210-3119
Phone (775) 315-4128

Other identifiers 2

IdentifierTypeStateIssuer
2013014MedicaidNV
050007310OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G54203CAMDAnesthesiology Physician
5549NVMDAnesthesiology Physician
MD158172ORMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen D Panter Crna LTD Past Accepting new patients
Scott G. Parkhill, M.D., P.C. Anesthesiology Past Accepting new patients

Organizations & group practices 2

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509667200000",
    "number": "1295749695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2846 NW ARIEL TER",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103119",
            "telephone_number": "775-315-4128",
            "fax_number": "775-883-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2846 NW ARIEL TER",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103119",
            "telephone_number": "775-883-2202",
            "fax_number": "775-883-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GISSEN",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2017-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G54203",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "5549",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD158172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2013014",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050007310",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.