Gregory A Lackides, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD151219 Issued in OR

Practice address

2020 Capitol St NE
Salem, OR 97303-3244

Phone

(503) 399-2424

Fax

(503) 375-7429

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Internal Medicine

Education

Stanford University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salem Clinic PCGroup PAC ID 7517954514, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• First Call Home Health Agency, LLC Home health agency, Salem, OR, CCN 387147
• Salem Hospital Hospital, Salem, OR, CCN 380051

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glackides39011@salemclinic.gardenplot.direct-ci.com

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.

• Salem Clinic, PC

  • General Practice Physician
  • Salem, OR
  • NPI 1912935594
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• First Call Home Health Agency, LLC

  • Home Health Agency
  • Salem, OR
  • NPI 1740260801
  Care Compare affiliation
• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1770522690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973030900",
            "telephone_number": "503-399-2424",
            "fax_number": "503-375-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973033244",
            "telephone_number": "503-399-2424",
            "fax_number": "503-375-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKIDES",
        "first_name": "GREGORY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD151219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP",
            "identifier": "CS4159",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080132461",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151219",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laboratory Corporation of America
• Laboratory Corporation of America
• Laboratory Corporation of America
• Ryan Lacasse, CADC-1
• James Kenneth Lace, M.D.
• Elizabeth Jane Lacroix, M.S., OTR
• Erin Lynne Lacy, M.A.
• Jaunda Ladd, PSS
• Ladies First Choice Inc
• Laura Ladue, LAC

• Internal Medicine Physician in Salem, OR
• Providers in Salem, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; 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.

Verify at the official NPI Registry.