| Central Oregon Dermatology, PC | |
|
388 Sw Bluff Dr Bend OR 97702-1360 | |
| (541) 678-0020 | |
| (541) 383-2174 |
| Full Name | Central Oregon Dermatology, PC |
|---|---|
| Speciality | Clinic/Center |
| Location | 388 Sw Bluff Dr, Bend, Oregon |
| Authorized Official Name and Position | Jodi Haney (OFFICE MANAGER) |
| Authorized Official Contact | 5413232181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Oregon Dermatology, PC 388 Sw Bluff Dr Bend OR 97702-1360 Ph: (541) 678-0020 | Central Oregon Dermatology, PC 388 Sw Bluff Dr Bend OR 97702-1360 Ph: (541) 678-0020 |
| NPI Number | 1336307875 |
|---|---|
| Provider Enumeration Date | 05/31/2008 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 5294806832 |
|---|---|
| Medicare Enrollment ID | O20080625000292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336307875 | NPI | - | NPPES |
| MD26648 | Other | OR | LICENSE |
| 241835 | Medicaid | OR | |
| 1609815166 | Other | OR | NPI (INDIVIDUAL) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD26648 (Oregon) | Primary |
| Provider Name | Mark a Hall |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1609815166 PECOS PAC ID: 4587667134 Enrollment ID: I20060821000295 |
| Provider Name | Alyssa D Abbey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992830152 PECOS PAC ID: 1355449596 Enrollment ID: I20070612000058 |
| Provider Name | Jill Kovalchick Conway |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255308656 PECOS PAC ID: 2466467162 Enrollment ID: I20150422001204 |
| Provider Name | Jill Olinger |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1396745303 PECOS PAC ID: 6204861131 Enrollment ID: I20170810000553 |
| Provider Name | Andrew Maxwell Williams |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235551292 PECOS PAC ID: 5597996660 Enrollment ID: I20180515002322 |
| Provider Name | Matthew Dean Firebaugh |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598019747 PECOS PAC ID: 8628220712 Enrollment ID: I20181023003255 |
| Provider Name | Molly Sue Nichols |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083154470 PECOS PAC ID: 9234476243 Enrollment ID: I20190129003680 |
| Provider Name | Paula S Gardner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699917567 PECOS PAC ID: 6002952397 Enrollment ID: I20260129002920 |
Pine Springs Health LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 711 Ne Irving Ave, Bend, OR 97701 Phone: 541-330-9110 |
St. Charles Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2500 Ne Neff Rd, Bend, OR 97701 Phone: 541-382-4321 |
Mosaic Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2577 Ne Courtney Dr Ste 100, Bend, OR 97701 Phone: 541-383-3005 |
Domani Medical LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 685 Se 3rd St, Bend, OR 97702 Phone: 541-516-4099 |
Adam Derr, P.C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 528 Ne Greenwood Ave, Bend, OR 97701 Phone: 541-385-7890 Fax: 541-388-2606 |
Driven Enterprises PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20700 Wandalea Dr, Bend, OR 97701 Phone: 435-669-2930 |