Individual provider Active NPI

Gary J Delorit, M.D.

  • Specialist
  • Gresham, OR
National Provider Identifier
1467520130
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD07434 Issued in OR
Practice address
24076 SE Stark St
Suite 230
Gresham, OR 97030-3373
Phone
(503) 465-5461
Fax
(503) 465-5468
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD07434 OR Primary

Addresses

Primary practice location

24076 SE Stark St
Suite 230
Gresham, OR 97030-3373

Mailing address

24076 SE Stark St
Suite 230
Gresham, OR 97030-3373
Phone (503) 465-5461

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD07434ORMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1467520130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST",
            "address_2": "SUITE 230",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303373",
            "telephone_number": "503-465-5461",
            "fax_number": "503-465-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST",
            "address_2": "SUITE 230",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303373",
            "telephone_number": "503-465-5461",
            "fax_number": "503-465-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELORIT",
        "first_name": "GARY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD07434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.