NPIMap

Individual provider Active NPI

Gary M Plant, MD

  • Family Medicine Physician
  • Madras, OR
National Provider Identifier
1417900317
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD24923 Issued in OR
Practice address
76 NE 12TH St
Madras, OR 97741-1827
Phone
(541) 475-3874
Fax
(541) 475-3503
NPI assigned
May 19, 2006
Last updated
Jun 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD24923 OR Primary

Addresses

Primary practice location

76 NE 12TH St
Madras, OR 97741-1827

Mailing address

76 NE 12TH St
Madras, OR 97741-1827
Phone (541) 475-3874

Other identifiers 1

IdentifierTypeStateIssuer
029099MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615000738 OR Practitioner - Family Practice 6406830785 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
East Tennessee State University Quillen College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madras Medical Group PCGroup PAC ID 5597758102, 5 clinicians

Practice addresses (Care Compare)

76 NE 12TH St
Madras, OR 97741-1827
Phone (541) 475-3874

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD24923ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Management Services of Oregon, LLC Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients

Locations

3113 Lawton Rd
Ste 250
Orlando, FL 32803
Phone (407) 480-5997

76 NE 12th St
Madras, OR 97741
Phone (541) 475-3874

Interoperability endpoints

  • Direct secure messaging: gary.plant.1@14009.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14009/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Madras Medical Group PCMadras, OR, CCN 383859 Rural health clinic 5% Or Greater Direct Ownership Interest
General Partnership Interest
Corporate Officer		 Jul 1, 2012
Jul 1, 2012
Jul 1, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1417900317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 NE 12TH ST",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977411827",
            "telephone_number": "541-475-3874",
            "fax_number": "541-475-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 NE 12TH ST",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977411827",
            "telephone_number": "541-475-3874",
            "fax_number": "541-475-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLANT",
        "first_name": "GARY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD24923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029099",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madras, OR

Sources for this page

Verify at the official NPI Registry.