Active NPI
Silvio Wanderley De Melo Jr., MD
- Gastroenterology Physician
- Portland, OR
National Provider Identifier
1508068487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MD185874
- Practice address
- 3181 SW Sam Jackson Park Rd
Portland, OR 97239 - Phone
- (503) 494-8577
- Fax
- (503) 494-7556
- NPI assigned
- Jun 4, 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | N1396 | TX | |
| Gastroenterology Physician | 207RG0100X | 29534 | AL | |
| Gastroenterology Physician | 207RG0100X | ME121074 | FL | |
| Gastroenterology Physician | 207RG0100X | MD185874 | OR | Primary |
| Internal Medicine Physician | 207R00000X | ME104528 | FL |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Mailing address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8577
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8DS775 | Other | TX | BLUE CROSS BLUE SHIELD OF TEXAS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME104528 | FL | MD | Internal Medicine Physician |
| MD185874 | OR | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Florida Jacksonville Physicians Inc | Gastroenterology | Current | Accepting new patients |
| University of Florida Jacksonville Physicians, Inc. | Internal Medicine | Current | Accepting new patients |
| University of Florida Jacksonville Physicians, Inc. | Current | Accepting new patients |
Locations
655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680
2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1144276452
-
- Gastroenterology Physician
- Jacksonville, FL
- NPI 1730349002
-
- Physiological Laboratory
- Jacksonville, FL
- NPI 1831800952
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531785600000",
"number": "1508068487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-8577",
"fax_number": "503-494-7556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "503-494-8577",
"fax_number": "503-494-7556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE MELO",
"first_name": "SILVIO",
"middle_name": "WANDERLEY",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-04",
"last_updated": "2018-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "TX",
"license": "N1396",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "AL",
"license": "29534",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME121074",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "OR",
"license": "MD185874",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME104528",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
"identifier": "8DS775",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.