MR. JURANDIR B DE MENEZES JR. (NPI# 1164462990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164462990 |
| Entity Type | Individual |
| Full Name | MR. JURANDIR B DE MENEZES JR. |
| Credential | PA-C |
| Practice Address |
3615 Nw Samaritan Dr Ste 201 Corvallis OR 97330-3771 |
| Mailing Address |
Po Box 1189 Corvallis OR 97339-1189 |
| Practice Telephone | 5417685930 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA01048 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA60041664 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L&I | 0253647 | 01 |
| Street Address |
3615 NW SAMARITAN DR STE 201 |
| City | CORVALLIS |
| State | OR |
| Zip Code | 97330-3771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316944572 | Anthony Charlies De Mory | Internal Medicine | 3615 Nw Samaritan Dr, Suite 203, Corvallis, OR 97330-3783 | 2005-07-02 |
| 1154763050 | Michelle Renae-pippel Keller | Physician Assistant | 3615 Nw Samaritan Dr, Suite 210, Corvallis, OR 97330-3783 | 2013-07-22 |
| 1063771152 | Good Samaritan Hospital Corvallis | Neurological Surgery | 3615 Nw Samaritan Dr, Suite 211, Corvallis, OR 97330-3783 | 2012-05-09 |
| 1144596479 | Good Samaritan Hospital Corvallis | Surgery | 3615 Nw Samaritan Dr, Suite 201, Corvallis, OR 97330-3783 | 2012-03-30 |
| 1528395969 | Crystal M Buglino | Physician Assistant | 3615 Nw Samaritan Dr, Suite 201, Corvallis, OR 97330-3783 | 2009-11-05 |
| 1073749396 | Poojitha Reddy Beravol | Internal Medicine | 3615 Nw Samaritan Dr, Suite 203, Corvallis, OR 97330-3783 | 2009-06-01 |
| 1801914734 | Ida B. Skinner | Clinical Nurse Specialist | 3615 Nw Samaritan Dr, Suite 201, Corvallis, OR 97330-3783 | 2007-03-27 |
| 1306976022 | Frank Clifford Roberson | Neurological Surgery | 3615 Nw Samaritan Dr, Suite 210, Corvallis, OR 97330-3783 | 2007-03-06 |
| 1942343025 | Jacqueline D Joss | Pharmacist | 3615 Nw Samaritan Dr, Suite 103, Corvallis, OR 97330-3783 | 2007-02-15 |
| 1326148552 | Christopher Michael Weinman | Physician Assistant | 3615 Nw Samaritan Dr, Suite 210, Corvallis, OR 97330-3783 | 2006-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754912 | Miya Claborn | Counselor | 4495 Se Hwy 20, Corvallis, OR 97330 | 2020-06-09 |
| 1548889017 | Greydi Olvera | Counselor | Childrens Farm Home 4455 Ne Hwy 20, Corvallius, OR 97330 | 2020-04-14 |
| 1053953992 | Andie Marie Gaipo | Counselor | 4455 Ne Hwy 20 - Children's Farm Home, Corvallis, OR 97330 | 2019-10-11 |
| 1740847177 | Stephen Jack Eccles | Behavior Technician | Trillium Children's Farm Home, 4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-05-21 |
| 1750944815 | Tiffany Rene Flinchpaugh | Counselor | Children's Farm Home 4455 Hwy 20, Corvallis, OR 97330 | 2019-04-15 |
| 1679035455 | Isaiah Mile Cassidy | Counselor | Children's Farm Home-4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-04-02 |
| 1982168399 | Haylee Cramblit | Counselor | Children's Farm Home 4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-01-30 |
| 1457835365 | Ashley Alyn Couch | Counselor | 4455 Hwy 20 Corvallis 97330, Corvallis, OR 97330 | 2018-09-18 |
| 1104318898 | Megan Gerding | Technician, Other | 996 Nw Circle Blvd Suite 103, Corvallis, OR 97330 | 2018-05-30 |
| 1700377108 | Pacific Hearing Services | Audiologist | 975 Nw Spruce Ave, Suite #101, Corvallis, OR 97330 | 2018-05-22 |
| Find all providers in zip 97330 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891065348 | Kindra T. Newhart | Physician Assistant | 996 Nw Circle Blvd Ste 103, Corvallis, OR 97330-1485 | 2011-12-30 |
| 1538241120 | Charlotte P Gardner | Physician Assistant | 5234 Sw Philomath Boulevard, Corvallis, OR 97333-1042 | 2006-10-20 |
| 1871682997 | Helen Kathleen Tennican | Physician Assistant | Oregon State University, 201 Plageman Building, Corvallis, OR 97331 | 2006-10-12 |
| 1215022512 | Charla Staggs | Physician Assistant | 2358 Nw Kings Blvd, Suite 100, Corvallis, OR 97330 | 2006-10-03 |
| 1962514836 | Nicole Dianne Wydra | Physician Assistant | 1740 Nw 9th St, Corvallis, OR 97330-2141 | 2006-08-31 |
| 1699798785 | Signe Harrang Wright | Physician Assistant | 5232 Sw Philomath Blvd, Corvallis, OR 97333-1042 | 2006-07-26 |
| 1154373868 | Dena M. Hulting | Physician Assistant | 3521 Nw Samaritan Dr, Suite 101, Corvallis, OR 97330-4744 | 2006-05-17 |
| 1376524694 | Daniel E Stenger | Physician Assistant | 3620 Nw Samaritan Dr, Suite 202, Corvallis, OR 97330-4714 | 2005-11-14 |
| 1487642799 | Dean D Jordan | Physician Assistant | 1122 Ne 2nd St, Corvallis, OR 97330-6227 | 2005-10-11 |
| 1285622589 | Stephen A Bennett | Physician Assistant | 1128 Ne 2nd St, Suite 201, Corvallis, OR 97330-6230 | 2005-10-11 |
| Find all providers in CORVALLIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.