NPIMap

Individual provider Active NPI

Michael J Kordus II, MD

  • Family Medicine Physician
  • White City, OR
National Provider Identifier
1013970540
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD162875 Issued in OR
Practice address
8385 Division Rd Ste 101
White City, OR 97503-1176
Phone
(541) 826-5853
Fax
(541) 826-5843
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 18

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.

Hospital & facility affiliations 4

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rogue Community Health 31 clinicians

Practice addresses (Care Compare)

19 Myrtle St
Medford, OR 97504-7337
Phone (541) 773-3863

Hospital & facility affiliations

  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
  • Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005
  • Providence Medford Medical Center Hospital, Medford, OR, CCN 380075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20150604002991 OR Practitioner - Family Practice 8123092129 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9800938NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rogue Community Health CurrentSince Jan 30, 2024 Accepting new patients
Wendy L Smith M.D. PC Past Accepting new patients
Rogue Community Health Past Accepting new patients
Harmony Grove Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Chatuge Regional Hospital Inc Past Accepting new patients
Emcare Physician Providers, Inc Emergency Medicine Past Accepting new patients
Harmony Grove Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Rogue Community Health Past Accepting new patients
Emcare Physician Providers Inc. Emergency Medicine Past Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients

Locations

19 Myrtle St
Medford, OR 97504
Phone (541) 773-4563

1221 Disk Dr
Medford, OR 97501

8385 Division Rd
White City, OR 97503
Phone (541) 500-0989

8385 Division Rd
Ste 101
White City, OR 97503
Phone (541) 826-5853

Interoperability endpoints

  • Direct secure messaging: mkordus292866@direct.ochin.org

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 9800938 NC
Family Medicine Physician 207Q00000X MD162875 OR Primary

Addresses

NPPES NPI Registry

Primary practice location

8385 Division Rd Ste 101
White City, OR 97503-1176

Mailing address

2859 State St
Suite 101
Medford, OR 97504-8495
Phone (541) 282-6505

Other identifiers 7

NPPES NPI Registry
IdentifierTypeStateIssuer
4113343OtherTNBLUE SHIELD
1118UOtherNCBCBS
P00024602OtherNCRAILROAD
247376291BMedicaidGA
3889674MedicaidTN
891118UMedicaidNC
500686045MedicaidOR

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 16, 2020.

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1013970540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2859 STATE ST",
            "address_2": "SUITE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048495",
            "telephone_number": "541-282-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8385 DIVISION RD STE 101",
            "city": "WHITE CITY",
            "state": "OR",
            "postal_code": "975031176",
            "telephone_number": "541-826-5853",
            "fax_number": "541-826-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORDUS",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "9800938",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD162875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "4113343",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1118U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00024602",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "247376291B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3889674",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891118U",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500686045",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White City, OR

Sources for this page

Verify at the official NPI Registry.