NPIMap

Individual provider Active NPI

Derek Carr Taylor, M.D.

  • Specialist
  • Portland, OR
National Provider Identifier
1487766911
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD23195 Issued in OR
Practice address
1130 NW 22ND Ave
Suite 410
Portland, OR 97210-2900
Phone
(503) 229-7137
Fax
(503) 241-0628
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 MD23195 OR Primary

Addresses

Primary practice location

1130 NW 22ND Ave
Suite 410
Portland, OR 97210-2900

Mailing address

1130 NW 22ND Ave
Suite 410
Portland, OR 97210-2900
Phone (503) 229-7137

Other identifiers 1

IdentifierTypeStateIssuer
286363MedicaidOR

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
I20040827000440 OR Practitioner - Gastroenterology 1153396742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Utah School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwest Gastroenterology Clinic LLCGroup PAC ID 7315935897, 13 clinicians

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 410
Portland, OR 97210-2911
Phone (503) 229-7137

Hospital & facility affiliations

  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as group
Quality
83.56
Promoting interoperability
100
Improvement activities
40
Cost
76.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy52
Upper gastrointestinal (GI) endoscopy for acid reflux94

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Gastroenterology Clinic LLC Specialist CurrentSince Aug 1, 2004 Accepting new patients
NGC Endoscopy Services LLC Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Legacy Emanuel Hospital & Health Center Past Accepting new patients

Locations

1130 NW 22nd Ave
Ste 410
Portland, OR 97210
Phone (503) 229-7137

1130 NW 22nd Ave
Ste 615
Portland, OR 97210
Phone (503) 229-7137

Interoperability endpoints

  • Direct secure messaging: dtaylor13810@direct.lhs.org

Organizations & group practices 4

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 7

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487766911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE",
            "address_2": "SUITE 410",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102900",
            "telephone_number": "503-229-7137",
            "fax_number": "503-241-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE",
            "address_2": "SUITE 410",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102900",
            "telephone_number": "503-229-7137",
            "fax_number": "503-241-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "DEREK",
        "middle_name": "CARR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD23195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286363",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.