Confederated Tribes Of The Grand Ronde Community Of Oregon - Medicare in Grand Ronde, OR

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Confederated Tribes Of The Grand Ronde Community Of Oregon is a medicare enrolled "Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy" provider in Grand Ronde, Oregon. Their current practice location is 9605 Grand Ronde Rd, Grand Ronde, Oregon. You can reach out to their office (for appointments etc.) via phone at (503) 879-2236.

Confederated Tribes Of The Grand Ronde Community Of Oregon is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Confederated Tribes Of The Grand Ronde Community Of Oregon is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1174666358.

Contact Information

Confederated Tribes Of The Grand Ronde Community Of Oregon
9605 Grand Ronde Rd,
Grand Ronde, OR 97347-9712
(503) 879-2236
(503) 879-5089

Map and Direction




Healthcare Provider's Profile

Full NameConfederated Tribes Of The Grand Ronde Community Of Oregon
TypeFacility
SpecialityIndian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy
Location9605 Grand Ronde Rd, Grand Ronde, Oregon
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1174666358
  • Provider Enumeration Date: 02/15/2007
  • Last Update Date: 02/28/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 6103717277
  • Enrollment ID: O20040320000494

Medical Identifiers

Medical identifiers for Confederated Tribes Of The Grand Ronde Community Of Oregon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1174666358NPI-NPPES
500786332MedicaidOR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist (* (Not Available))Secondary
208D00000XGeneral Practice (* (Not Available))Secondary
261QC1500XClinic/center - Community Health (* (Not Available))Secondary
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) 126883 (Oregon)Secondary
261QR0200XClinic/center - Radiology 445142 (Oregon)Secondary
291U00000XClinical Medical Laboratory 38D0862855 (Oregon)Secondary
101Y00000XCounselor (* (Not Available))Secondary
101YA0400XCounselor - Addiction (substance Use Disorder) (* (Not Available))Secondary
111N00000XChiropractor (* (Not Available))Secondary
1223G0001XDentist - General Practice (* (Not Available))Secondary
333600000XPharmacy 1559 (Oregon)Secondary
363LF0000XNurse Practitioner - Family (* (Not Available))Secondary
363LP2300XNurse Practitioner - Primary Care (* (Not Available))Secondary
332800000XIndian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Confederated Tribes Of The Grand Ronde Community Of Oregon acts as a billing entity for following providers:
Provider NameMatthew E Grady
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1811951569
PECOS PAC ID: 7911080999
Enrollment ID: I20080214000082
Provider NameLance Loberg
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1932180734
PECOS PAC ID: 5799855649
Enrollment ID: I20080603000856
Provider NameRandall E Blome
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1861457384
PECOS PAC ID: 9830222504
Enrollment ID: I20100802000365
Provider NameGrant William Knowles
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1710362058
PECOS PAC ID: 9739484494
Enrollment ID: I20160218000997
Provider NameDenise B Fellows
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1174060701
PECOS PAC ID: 4981965225
Enrollment ID: I20180228001917
Provider NameAnandam Hilde
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1861753352
PECOS PAC ID: 1658667944
Enrollment ID: I20180517001656
Provider NameTerri Lynn Knowles
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1922554542
PECOS PAC ID: 1658610704
Enrollment ID: I20190306003701
Provider NameJames R Laidler
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1629322888
PECOS PAC ID: 2163663048
Enrollment ID: I20191014003091
Provider NameKatie Jo Martin
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1770970998
PECOS PAC ID: 2163732793
Enrollment ID: I20191031002103
Provider NameChristopher Michael Brown
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1518353549
PECOS PAC ID: 5193037166
Enrollment ID: I20191111002854
Provider NameAnnette N Sampson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215241708
PECOS PAC ID: 5991172926
Enrollment ID: I20221104000945
Provider NameTricia Raye Hayden
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649994286
PECOS PAC ID: 0446375943
Enrollment ID: I20230620000468
Provider NameLaura Ashley Michielsen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518424787
PECOS PAC ID: 6406288521
Enrollment ID: I20231213001249
Provider NameMaret Banks
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1821763137
PECOS PAC ID: 3779935416
Enrollment ID: I20240118002751
Provider NameKarrie Martin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649624404
PECOS PAC ID: 3577952290
Enrollment ID: I20240125004180
Provider NameJill Goodwin
Provider TypePractitioner - Marriage And Family Therapist
Provider IdentifiersNPI Number: 1477096386
PECOS PAC ID: 9335585892
Enrollment ID: I20240307000856
Provider NameMaurice Ajaifia
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083288682
PECOS PAC ID: 4880130731
Enrollment ID: I20240726002865
Provider NameDeborah A Samoson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801804430
PECOS PAC ID: 6204856875
Enrollment ID: I20240823000900

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Confederated Tribes Of The Grand Ronde Community Of Oregon is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Confederated Tribes Of The Grand Ronde Community Of Oregon
Po Box 338,
Grand Ronde, OR 97347-0338

Ph: (503) 879-2236		Confederated Tribes Of The Grand Ronde Community Of Oregon
9605 Grand Ronde Rd,
Grand Ronde, OR 97347-9712

Ph: (503) 879-2236

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.