Individual provider Active NPI

Dean Taylor, D.O.

  • Internal Medicine Physician
  • Gresham, OR
National Provider Identifier
1689964116
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO166143 Issued in OR
Practice address
24800 SE Stark St
Gresham, OR 97030
Phone
(503) 413-8407
NPI assigned
Apr 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO166143 OR Primary

Addresses

Primary practice location

24800 SE Stark St
Gresham, OR 97030

Mailing address

PO Box 3777
Portland, OR 97208-3777
Phone (503) 413-3900

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
I20140903001486 OR Practitioner - Internal Medicine 6507084613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Western University of Health Sciences College of Dental Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

24800 SE Stark St
Gresham, OR 97030-3378
Phone (503) 413-8988

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO166143ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC Internal Medicine CurrentSince Aug 1, 2014 Accepting new patients
Silverton Health Current Accepting new patients
Silverton Health CurrentSince Mar 20, 2020 Accepting new patients
Legacy Clinics LLC CurrentSince Aug 1, 2014 Accepting new patients
Silverton Health CurrentSince Mar 20, 2020 Accepting new patients

Locations

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

Organizations & group practices 5

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 1

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": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1689964116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "503-413-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24800 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-413-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "DEAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-18",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO166143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.