Gajanan Nilaver, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD14509 Issued in OR

Practice address

10202 SE 32ND Ave
Suite 703
Portland, OR 97222-3610

Phone

(503) 513-8020

NPI assigned

May 8, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: gnilaver118059@oc.providencedirect.org

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1386693588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10202 SE 32ND AVE",
            "address_2": "SUITE 703",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972223610",
            "telephone_number": "503-513-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILAVER",
        "first_name": "GAJANAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD14509",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD14509",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00479379",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130708",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yana A Nikitin
• Mykola Nikolaiev, LMT
• Vahagn Calvin Nikolian, M.D.
• Lisa Ann Nikunen, PSY.D.
• Tara Crishann Nikzi, MAC. OM.
• Jordan Alexander Niles
• Sally Lindsay Niles, MD
• Brit Amalie Nilsen, M.D.
• Stacia Lynnae Nilson, LPC
• Saelj Astrid Nilsson, FNP

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.