| Audra Jo Burdulis, PA-C | |
|
108 Nw Sisemore St Ste 120, Bend, OR 97703-2869 | |
| (541) 213-2133 | |
| Not Available |
| Full Name | Audra Jo Burdulis |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 23 Years |
| Location | 108 Nw Sisemore St Ste 120, Bend, Oregon |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124075205 | NPI | - | NPPES |
| 2009751 | Medicaid | WA | |
| G8891360 | Other | WA | MEDICARE W VALLEY MEDICAL GROUP - RENTON |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA10004625 (Washington) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA228080 (Oregon) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Icco Llc | 1355406729 | 133 |
| Entity Name | Icco LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407004757 PECOS PAC ID: 1355406729 Enrollment ID: O20090218000510 |
| Mailing Address | Practice Location Address |
|---|---|
| Audra Jo Burdulis, PA-C 600 Jefferson St Ste 600, Lafayette, LA 70501-6987 Ph: (337) 202-0720 | Audra Jo Burdulis, PA-C 108 Nw Sisemore St Ste 120, Bend, OR 97703-2869 Ph: (541) 213-2133 |
David Berg Kirkpatrick, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1342 Ne Medical Center Dr Ste 101, Bend, OR 97701 Phone: 541-382-3344 Fax: 541-382-1681 |
Calli Elizabeth Rogowitz, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 815 Sw Bond St, Bend, OR 97702 Phone: 541-382-4900 |
Christopher R Russell, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2065 Ne Tucson Way Apt 110, Bend, OR 97701 Phone: 541-383-3005 Fax: 541-383-1883 |
Jean M Brown, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2500 Ne Neff Rd, Bend, OR 97701 Phone: 541-388-1636 Fax: 541-388-1719 |
Gregory R. Lang, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1501 Ne Medical Center Dr, Bend, OR 97701 Phone: 541-382-4900 Fax: 541-706-2398 |
Hope Elizabeth Cline, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 19393 Sw Laurelhurst Way, Bend, OR 97702 Phone: 717-823-0058 |
Dayna Dobson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2500 Ne Neff Rd, Bend, OR 97701 Phone: 541-388-4333 Fax: 541-388-1719 |