Individual provider Active NPI

Janel Carmela Desalvo, MD

  • Internal Medicine Physician
  • Tualatin, OR
National Provider Identifier
1770089468
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD197615 Issued in OR
Practice address
19300 SW 65TH Ave
Tualatin, OR 97062-7706
Phone
(503) 692-1212
NPI assigned
Apr 2, 2018
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 MD197615 OR Primary

Addresses

Primary practice location

19300 SW 65TH Ave
Tualatin, OR 97062-7706

Mailing address

10964 SW Annand Hill CT
Tigard, OR 97224-3897
Phone (623) 282-5622

Other practice location 1

10964 SW Annand Hill Ct
Tigard, OR 97224-3897
Phone (503) 946-6902

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
I20210715000931 OR Practitioner - Internal Medicine 0143570283 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arizona College of Medicine, 2018
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)

19300 SW 65TH Ave
Meridian Park Hosp
Portland, OR 97062-7706
Phone (503) 692-1212

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 Medicine

State licenses

LicenseStateTypeSpecialty
MD197615ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 26, 2021 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Aug 23, 2022 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880

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

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

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.

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1770089468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10964 SW ANNAND HILL CT",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972243897",
            "telephone_number": "623-282-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19300 SW 65TH AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627706",
            "telephone_number": "503-692-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10964 SW Annand Hill Ct",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972243897",
            "country_code": "US",
            "telephone_number": "503-946-6902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESALVO",
        "first_name": "JANEL",
        "middle_name": "CARMELA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD197615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

Verify at the official NPI Registry.