Gerard V Lasalle, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD00017511 Issued in WA

Practice address

1141 Beach Dr E
Port Orchard, WA 98366-4937

Phone

(360) 895-4700

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Northwest Emergency Physicians LLC

  dba Nep

  • Emergency Medicine Physician
  • Arlington, WA
  • NPI 1235172370
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1376587899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 NW 136TH AVE.",
            "address_2": "BLDG: H, SUITE: 100 MSC 11607-0004",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "33323",
            "telephone_number": "865-500-1856",
            "fax_number": "865-560-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 BEACH DR E",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664937",
            "telephone_number": "360-895-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASALLE",
        "first_name": "GERARD",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00017511",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "MD00017511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0190073",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0170816",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "LA1174",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "LA8001",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "2165LA",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8328601",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0170825",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Marie Lapolla, PTA
• Anita L Larae, LMHC
• Dena Larsen, DPT
• Mallory Larson-Burns
• Jessica Lee Larson, CCC-SLP
• Jensen Lau, RPH
• Crystal R Laub, LMP
• Rhonda E. Law, PT
• Douglas M Lawrence, CDP
• Mitzi Gayle Lawson, LMP

• General Practice Physician in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• General Practice Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.