Active NPI
Nicholas Landau Gideonse, MD
- Family Medicine Physician
- Cottage Grove, OR
National Provider Identifier
1639184146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD17811
- Practice address
- 1515 Village Dr
Cottage Grove, OR 97424-9700 - Phone
- (541) 767-5200
- Fax
- (541) 767-5310
- NPI assigned
- Jul 31, 2006
- Last updated
- Oct 14, 2024
- 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 | MD17811 | OR | Primary |
Addresses
Primary practice location
1515 Village Dr
Cottage Grove, OR 97424-9700
Mailing address
1400 SE Oak St
Portland, OR 97214-1430
Other practice location 1
3930 SE Division St
Portland, OR 97202-1643
Phone (503) 418-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 063743 | Medicaid | OR |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
170 Ford Rd
John Day, OR 97845-2009
Phone (541) 575-1311
Hospital & facility affiliations
- Signature Healthcare at Home
- Sacred Heart Home Health
- Peacehealth Cottage Grove Community Medical Center
- Sacred Heart Medical Center - Riverbend
- Blue Mountain Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 96.74
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.11 of 100
- Quality
- 84.29
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Mountain Hospital District | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients | |
| Peacehealth Medical Group Cottage Grove | Current | Accepting new patients |
Locations
1515 Village Dr
Cottage Grove, OR 97424
Phone (541) 767-5200
170 Ford Rd
John Day, OR 97845
Phone (541) 575-1311
Interoperability endpoints
- ngideonse665148@direct.peacehealth.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Strawberry Wilderness Community Clinic
- Rural Health Clinic/Center
- John Day, OR
- NPI 1568536035
-
dba Cottage Grove Community Medical CT
- Critical Access Hospital
- Cottage Grove, OR
- NPI 1902892391
-
- Multi-Specialty Clinic/Center
- Creswell, OR
- NPI 1780631267
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- John Day, OR
- NPI 1356414395
-
- Psychiatric Hospital Unit
- Eugene, OR
- NPI 1568236974
-
dba Cottage Grove Community Medical CT
- Critical Access Hospital
- Cottage Grove, OR
- NPI 1902892391
-
dba Signature Healthcare at Home
- Home Health Agency
- Eugene, OR
- NPI 1013733211
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728864000000",
"number": "1639184146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 SE OAK ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972141430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 VILLAGE DR",
"city": "COTTAGE GROVE",
"state": "OR",
"postal_code": "974249700",
"telephone_number": "541-767-5200",
"fax_number": "541-767-5310"
}
],
"practiceLocations": [
{
"address_1": "3930 SE Division St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972021643",
"country_code": "US",
"telephone_number": "503-418-3900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GIDEONSE",
"first_name": "NICHOLAS",
"middle_name": "LANDAU",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2024-10-14",
"certification_date": "2024-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD17811",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "063743",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cottage Grove, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.