| Central Oregon Internal Medicine LLC | |
|
2275 Ne Doctors Dr Ste 7 Bend OR 97701-6324 | |
| (541) 728-2114 | |
| (541) 749-2126 |
| Full Name | Central Oregon Internal Medicine LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2275 Ne Doctors Dr Ste 7, Bend, Oregon |
| Authorized Official Name and Position | Matthew Jan Ingrassia (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5417282114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Oregon Internal Medicine LLC 2275 Ne Doctors Dr Ste 7 Bend OR 97701-6324 Ph: (541) 728-2114 | Central Oregon Internal Medicine LLC 2275 Ne Doctors Dr Ste 7 Bend OR 97701-6324 Ph: (541) 728-2114 |
| NPI Number | 1184439820 |
|---|---|
| Provider Enumeration Date | 02/10/2025 |
| Last Update Date | 04/14/2025 |
| Certification Date | 04/14/2025 |
| Medicare PECOS PAC ID | 6204353022 |
|---|---|
| Medicare Enrollment ID | O20250506000933 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184439820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Matthew Ingrassia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700142122 PECOS PAC ID: 5294050258 Enrollment ID: I20240918002935 |
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