Individual provider Active NPI

Kamran Ghalili, MD

  • Cardiovascular Disease Physician
  • Salem, OR
National Provider Identifier
1417977166
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD26864 Issued in OR
Practice address
610 Hawthorne Ave SE Ste 110
Salem, OR 97301
Phone
(503) 814-4440
Fax
(503) 814-4444
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X MD26864 OR
Cardiovascular Disease Physician 207RC0000X MD26864 OR Primary

Addresses

Primary practice location

610 Hawthorne Ave SE Ste 110
Salem, OR 97301

Mailing address

PO Box 886
Salem, OR 97308-0886
Phone (503) 814-4440

Other practice location 1

665 Winter St SE Ste B0350
Salem, OR 97301-3934
Phone (503) 814-4440

Other identifiers 2

IdentifierTypeStateIssuer
28417MedicaidOR
R152645OtherORMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20061018000164 OR Practitioner - Cardiovascular Disease (Cardiology) 9931017647 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Albert Einstein College of Medicine of Yeshiva University, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oregon Heart Center PCGroup PAC ID 1951438472, 12 clinicians
Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

610 Hawthorne Ave SE
Suite 110
Salem, OR 97301-5378
Phone (503) 814-4440

890 Oak St SE
Salem, OR 97301-3905
Phone (503) 561-5200

Hospital & facility affiliations

  • Salem Hospital Hospital, Salem, OR, CCN 380051
  • Salem Health West Valley Hospital, Dallas, OR, CCN 381308

Merit-based Incentive Payment System (MIPS)

Final score
90.49 of 100Reported as group
Quality
76.77
Promoting interoperability
100
Improvement activities
40
Cost
88.8

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD26864ORMDCardiovascular Disease Physician
26864ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health West Valley CurrentSince Mar 27, 2012 Accepting new patients
Salem Health CurrentSince Aug 1, 2006 Accepting new patients
Oregon Heart Center PC Cardiovascular Disease CurrentSince Feb 19, 2010 Accepting new patients
Salem Health CurrentSince Aug 1, 2006 Accepting new patients
Nebraska Heart Institute PC Cardiovascular Disease Past Accepting new patients
Jeffrey a Passer MD PC Past Accepting new patients

Locations

525 SE Washington St
Dallas, OR 97338
Phone (503) 623-7344

9605 Grand Ronde Rd
Grand Ronde, OR 97347
Phone (503) 879-2002

1601 Monmouth St
Ste 100
Independence, OR 97351
Phone (503) 623-8301

875 Oak St SE
Salem, OR 97301
Phone (503) 561-5719

890 Oak St SE
Salem, OR 97301
Phone (503) 585-0830

610 Hawthorne Ave SE
Ste 110
Salem, OR 97301
Phone (503) 561-7160

1049 Edgewater St NW
#150
Salem, OR 97304
Phone (503) 814-3343

665 Winter St SE
Ste B0350
Salem, OR 97301
Phone (503) 814-4440

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

Interoperability endpoints

  • Direct secure messaging: kghalili3536653@oc.providencedirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1417977166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 886",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973080886",
            "telephone_number": "503-814-4440",
            "fax_number": "503-814-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 HAWTHORNE AVE SE STE 110",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-814-4440",
            "fax_number": "503-814-4444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "665 Winter St SE Ste B0350",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973013934",
            "country_code": "US",
            "telephone_number": "503-814-4440",
            "fax_number": "503-814-4444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHALILI",
        "first_name": "KAMRAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OR",
            "license": "MD26864",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD26864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28417",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "R152645",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.