John M Custis, MD
John M Custis is a Internal Medicine Physician provider (Internal Medicine) practicing in Gresham, OR, registered in the NPPES registry with NPI 1770561813 since 2006. The credential MD stands for Doctor of Medicine.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1770561813 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | John M Custis |
| Credential | MD |
| Sex | Male |
| Practice address | 24900 SE STARK, STE 109, Gresham, OR, 97030 |
| Phone | 5036671015 |
| Fax | 5036670406 |
| Enumeration date | 2006-01-09 |
| Last updated in NPPES | 2007-12-21 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207R00000X | Internal Medicine Physician | Primary | MD09069 | OR |
MD — Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 276659 | Medicaid | OR | — |
Copy-ready billing details
Provider: John Custis, MD NPI: 1770561813 Taxonomy: 207R00000X (Internal Medicine Physician) Address: 24900 SE STARK, STE 109, Gresham, OR, 97030
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1386602266 | Julio Ordonez | Individual | Neurological Surgery Physician | Gresham, OR |
Verify this record
Cross-check NPI 1770561813 against the authoritative CMS record: view John M Custis on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-12-21.