Individual provider Active NPI

Daniel G McAllister, MD

  • Pediatrics Physician
  • Medford, OR
National Provider Identifier
1629079504
Registry record updated Jun 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD171590 Issued in OR
Practice address
2825 E Barnett Rd
Dept of Pediatrics
Medford, OR 97504-8332
Phone
(541) 789-4231
Fax
(541) 789-5934
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 10519 MT
Pediatrics Physician 208000000X M4333 TX
Pediatrics Physician 208000000X MD171590 OR Primary

Addresses

Primary practice location

2825 E Barnett Rd
Dept of Pediatrics
Medford, OR 97504-8332

Mailing address

2620 E Barnett Rd
Medford, OR 97504-8344
Phone (541) 789-4281

Other identifiers 1

IdentifierTypeStateIssuer
0071247MedicaidMT

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
I20150619002247 OR Practitioner - Pediatric Medicine 7012907918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Texas HSC at Houston School of Dentistry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

625 SW Ramsey Ave
Suite a
Grants Pass, OR 97527-5808
Phone (541) 507-2290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD171590ORMDPediatrics Physician
10519MTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asante Physician Partners Pediatrics CurrentSince Jul 1, 2015 Accepting new patients

Locations

625 SW Ramsey Ave
Ste A
Grants Pass, OR 97527
Phone (541) 474-5004

2620 E Barnett Rd
Ste H
Medford, OR 97504
Phone (541) 789-4281

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1629079504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048344",
            "telephone_number": "541-789-4281",
            "fax_number": "541-789-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD",
            "address_2": "DEPT OF PEDIATRICS",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-4231",
            "fax_number": "541-789-5934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCALLISTER",
        "first_name": "DANIEL",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MT",
            "license": "10519",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M4333",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD171590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0071247",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.