Bhavani Peddagovindu, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD158124 Issued in OR

Practice address

1900 Woodland Dr
Coos Bay, OR 97420-2045

Phone

(541) 267-5151

Fax

(541) 266-4572

NPI assigned

Sep 24, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Geriatric Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Bend Medical Center IncGroup PAC ID 5597677716, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bpeddagovindu124886@secure.stcharleshealthcare.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Bend Medical Center Inc

  dba NBMC-Main

  • Multi-Specialty Clinic/Center
  • Coos Bay, OR
  • NPI 1407812365
  Medicare reassignment Care Compare group NPD
• Bay Area Hospital District

  dba Bay Area Hospital

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Medicare reassignment NPD
• Bay Area Hospital District

  • Home Health Agency
  • North Bend, OR
  • NPI 1215018197
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bay Area Hospital District

  dba Bay Area Hospital

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1013167303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202045",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202045",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDDAGOVINDU",
        "first_name": "BHAVANI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD158124",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "OR",
            "license": "MD158124",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01278284",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBMC GROUP MEDICAID",
            "identifier": "161133",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBMC GROUP NPI",
            "identifier": "1407812365",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBMC GROUP TAX ID FOR BILLING",
            "identifier": "930635514",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500648004",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBMC-GROUP MEDICARE",
            "identifier": "R0000WFBTV",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Andreas Pasternak, MD
• Prabhakar Ashokkumar Patel, MD
• Ravindra Patel, M.D.
• Jason Allen Paul, PSS, CRM
• Andrea Paullus, RN, RNFA
• Ryan D Pederson, D.P.M.
• Ruth Ann Peet
• Stephanie Perkins, FNP
• David Thomas Petley, PHARM D
• Kristy Leigh Petrie, RN, BSN, FAACM

• Internal Medicine Physician in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.