Individual provider Active NPI

Peter M. Shepard, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Bend, OR
National Provider Identifier
1023051232
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
MD187561 Issued in OR
Practice address
2450 NE Mary Rose PL Ste 120
Bend, OR 97701-7132
Phone
(541) 382-3100
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X MD187561 OR Primary

Addresses

Primary practice location

2450 NE Mary Rose PL Ste 120
Bend, OR 97701-7132

Mailing address

2450 NE Mary Rose PL Ste 120
Bend, OR 97701-7132
Phone (541) 382-3100

Other practice location 1

2855 NW Crossing Dr Ste 101
Bend, OR 97703-7049
Phone (541) 382-3100

Other practice location 2

1020 SW Indian Ave Ste 102
Redmond, OR 97756-3037
Phone (541) 382-3100

Other practice location 3

1734 Lark St
Klamath Falls, OR 97601-4346
Phone (541) 859-2924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180824001512 OR Practitioner - Otolaryngology 2264585082 Reassigns benefits to 1 organization
I20230510001006 AZ Practitioner - Otolaryngology 2264585082 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1734 Lark St
Klamath Falls, OR 97601-4346
Phone (541) 859-2924

2450 NE Mary Rose PL
Suite 120
Bend, OR 97701-7132
Phone (541) 382-3100

2855 NW Crossing Dr
Suite 101
Bend, OR 97703-7049
Phone (541) 382-3100

Hospital & facility affiliations

  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047
  • Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

Merit-based Incentive Payment System (MIPS)

Final score
92.41 of 100Reported as group
Quality
97.23
Improvement activities
40
Cost
78.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2009-0111NMMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cobre Valley Regional Medical Center Current Accepting new patients
Cobre Valley Regional Medical Center CurrentSince Jun 7, 2024 Accepting new patients

Locations

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

1134 W US Highway 60
Superior, AZ 85173
Phone (520) 689-2423

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AEDCAA/Endpoint/AEDCAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/HDAHAA/Endpoint/HDAHAA
  • Direct secure messaging: kge8559@yourcarecommunity.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1023051232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 NE MARY ROSE PL STE 120",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017132",
            "telephone_number": "541-382-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 NE MARY ROSE PL STE 120",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017132",
            "telephone_number": "541-382-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2855 NW Crossing Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977037049",
            "country_code": "US",
            "telephone_number": "541-382-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1020 SW Indian Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977563037",
            "country_code": "US",
            "telephone_number": "541-382-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1734 Lark St",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976014346",
            "country_code": "US",
            "telephone_number": "541-859-2924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "PETER",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "OR",
            "license": "MD187561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.