Michael V. Delollis, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD175003 Issued in OR

Practice address

1220 NW Kings Blvd
Corvallis, OR 97330-2521

Phone

(541) 321-8552

NPI assigned

Jul 13, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, OR2 enrollments

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 2

Specialty

Psychiatry

Education

University of New Mexico School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Silver Falls Dermatology, LLC

  • Ambulatory Surgical Clinic/Center
  • Seattle, WA
  • NPI 1417163635
  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1366440323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 NW KINGS BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973302521",
            "telephone_number": "541-321-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 NW KINGS BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973302521",
            "telephone_number": "541-321-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOLLIS",
        "first_name": "MICHAEL",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G59726",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD11748",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD175003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500708139",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne Louise Delander, RPH, PHARMD
• Gary Eugene Delander
• Madison Nicole Delmendo, RD
• Brian Lee Delmonaco, MD
• Caden Deloach, BS PUBLIC HEALTH
• Rebecca Lynn Delurey
• Camille Demarcus, DO
• Rebecca Dee Demarest, MSW, M.A.
• Monica H Demasi, M.D.
• Melissa Demers

• Psychiatry Physician in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.