A P Aversano, D.O.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

DO10193 Issued in OR

Practice address

9200 SE 91St Ave
Portland, OR 97266-6756

Phone

(509) 837-4366

Fax

(509) 837-4344

NPI assigned

Jan 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952459190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2053",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970350632",
            "telephone_number": "509-837-4366",
            "fax_number": "509-837-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 SE 91ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972666756",
            "telephone_number": "509-837-4366",
            "fax_number": "509-837-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERSANO",
        "first_name": "A",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "DO10193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232405",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyudmila N Avanesov, QMHA
• Adam Avant, MD
• Rupali Surendra Avasare, M.D.
• Avatar Healing Arts
• Larisa Avatyuk, LMT
• Mikayla Avery-Hull
• Anne Katharine Avery, MD
• Patricia Monique Keiki O Avery
• Stefanie B Avery, FNP-C
• Stephanie Avery, M.ED., LPC

• Neurology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Neurology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.