Active NPI
Michael Puerini, MD
- Family Medicine Physician
- Salem, OR
National Provider Identifier
1447395710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD 15096
- Practice address
- 3405 Deer Park Dr SE
Salem, OR 97310-9302 - Phone
- (503) 373-0168
- Fax
- (503) 378-6732
- NPI assigned
- Feb 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD 15096 | OR | Primary |
Addresses
Primary practice location
3405 Deer Park Dr SE
Salem, OR 97310-9302
Mailing address
3405 Deer Park Dr SE
Salem, OR 97310-9302
Phone (503) 373-0168
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD 15096 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multi-Cultural Consultants, LTD | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Salem, OR
- NPI 1417361312
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447395710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3405 DEER PARK DR SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973109302",
"telephone_number": "503-373-0168",
"fax_number": "503-378-6732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3405 DEER PARK DR SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973109302",
"telephone_number": "503-373-0168",
"fax_number": "503-378-6732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUERINI",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD 15096",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.