Individual provider Active NPI

Karl Grant Hyde, MD

  • Anesthesiology Physician
  • Salem, OR
National Provider Identifier
1366494304
Registry record updated Aug 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD25679 Issued in OR
Practice address
1445 State St
Salem, OR 97301-4248
Phone
(503) 566-3507
Fax
(503) 581-4405
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD25679 OR Primary

Addresses

Primary practice location

1445 State St
Salem, OR 97301-4248

Mailing address

PO Box 3024
Plattsburgh, NY 12901-0298
Phone (518) 561-1603

Other identifiers 3

IdentifierTypeStateIssuer
213437MedicaidOR
8424087MedicaidWA
P00303137OtherORRR 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
MD25679ORMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lodestone Health, PLLC PastSince May 20, 2012 Accepting new patients
Oregon Anesthesiology Group PC Anesthesiology PastSince Jul 25, 2019 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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1366494304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3024",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129010298",
            "telephone_number": "518-561-1603",
            "fax_number": "518-561-0179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014248",
            "telephone_number": "503-566-3507",
            "fax_number": "503-581-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDE",
        "first_name": "KARL",
        "middle_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD25679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213437",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8424087",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00303137",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.