Douglas Duane Huntley, PA-C
Individual provider Active NPI Surgical Physician Assistant · Stayton, OR
NPI 1043365513 · NPPES record last updated Apr 15, 2022
Key facts
- NPI
- 1043365513
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- PA00977 (OR)
- Practice address
- 1377 N 10TH Ave
Stayton, OR 97383-2037 - Phone
- (503) 769-8470
- Fax
- (503) 769-9860
- NPI assigned
- Jan 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 15
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Santiam Memorial Hospital
Practice addresses (Care Compare)
1369 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-8470
1371 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-3785
1373 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-9522
1375 N 10TH Ave
Suite B
Stayton, OR 97383-2099
Phone (503) 769-7546
1401 N 10TH Ave
Stayton, OR 97383-1311
Phone (503) 769-2175
Hospital & facility affiliations
- Santiam Hospital & Clinics
- Grays Harbor Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040920000149 | OR | Practitioner - Physician Assistant | 1254309156 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00977 | OR | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santiam Memorial Hospital | Current |
Accepting new patients | |
| Santiam Memorial Hospital | Current |
Accepting new patients | |
| Oregon Healthcare Resources, LLC | Current |
Accepting new patients | |
| Oregon Healthcare Resources, LLC | Current |
Accepting new patients | |
| Firstcare Medical Foundation | Past |
Accepting new patients | |
| Santiam Memorial Hospital | Past | Accepting new patients | |
| Good Samaritan Hospital Corvallis | Past | Accepting new patients | |
| Santiam Memorial Hospital | Past | Accepting new patients |
Locations
600 Country Club Rd
Eugene, OR 97401
Phone (541) 242-4172
2000 N 19th St
Springfield, OR 97477
Phone (541) 284-1694
1375 N 10th Ave
Ste B
Stayton, OR 97383
Phone (503) 769-7546
1369 N 10th Ave
Stayton, OR 97383
Phone (503) 769-7546
Interoperability endpoints
- ddhuntle@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA00977 | OR | Yes |
Addresses
Primary practice location
1377 N 10TH Ave
Stayton, OR 97383-2037
Mailing address
1377 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-8470
Other practice location 1
3640 NW Samaritan Dr
Corvallis, OR 97330-3784
Phone (541) 757-3700
Other practice location 2
600 Country Club Rd
Eugene, OR 97401-2240
Phone (541) 242-4812
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500614409 | Medicaid | OR |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | douglas.huntley.1@14369.direct.athenahealth.com |
Other providers in Stayton, OR
- Henry Frank Storey OD
- Joshua Andrew Hevel
- Matthew Jacob Hill
- Marlee R. Hoffman
- Nathan Daniel Hoover
- Danielle M Hurl
- Brianna Isaac
- Chad Michael Jamison
- Jeanne L Fitzpatrick MD PC
- Jeff Van Kirk, DMD, PC
All providers in Stayton, OR · Surgical Physician Assistant in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.