NPIMap

Individual provider Active NPI

Craig Thomas Gillis, D.O.

  • Orthopaedic Surgery Physician
  • Lake Oswego, OR
National Provider Identifier
1861755126
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
DO193270 Issued in OR
Practice address
4103 Mercantile Dr
Lake Oswego, OR 97035
Phone
(503) 850-9940
Fax
(503) 850-6709
NPI assigned
Jun 21, 2012
Last updated
May 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X DO193270 OR Primary
Orthopaedic Surgery Physician 207X00000X PG157927 OR
Orthopaedic Hand Surgery Physician 207XS0106X DO193270 OR

Addresses

Primary practice location

4103 Mercantile Dr
Lake Oswego, OR 97035

Mailing address

4103 Mercantile Dr
Lake Oswego, OR 97035-2556
Phone (503) 850-9940

Other practice location 1

3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 768-4906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200514000890 OR Practitioner - Orthopedic SurgeryPractitioner - Hand Surgery 1759659519 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Hand Surgery
Education
Western University of Health Sciences College of Dental Med, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Orthopaedics, LLPGroup PAC ID 4789725607, 18 clinicians

Practice addresses (Care Compare)

4103 Mercantile Dr
Lake Oswego, OR 97035-2556
Phone (503) 850-9940

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)15
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO193270ORMDOrthopaedic Surgery Physician
PG157927ORMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Apr 15, 2021 Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 15, 2021 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Summit Orthopaedics, LLP Orthopaedic Surgery CurrentSince Jan 13, 2026 Accepting new patients
Craig T Gillis DO PC Orthopaedic Surgery CurrentSince Mar 24, 2020 Accepting new patients
TS Pos Billings L L C Past Accepting new patients
Legacy Emanuel Hospital & Health Center Past Accepting new patients

Locations

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

4103 Mercantile Dr
Lake Oswego, OR 97035
Phone (503) 850-9940

Organizations & group practices 8

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 6

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": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1861755126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 MERCANTILE DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352556",
            "telephone_number": "503-850-9940",
            "fax_number": "503-850-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4103 MERCANTILE DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "97035",
            "telephone_number": "503-850-9940",
            "fax_number": "503-850-6709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303737",
            "country_code": "US",
            "telephone_number": "541-768-4906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "CRAIG",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-21",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "DO193270",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "PG157927",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "OR",
            "license": "DO193270",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.