Individual provider Active NPI

Terry D Rolan, MD

  • Neurology Physician
  • Bend, OR
National Provider Identifier
1063479103
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD212800 Issued in OR
Practice address
1501 NE Medical Center Dr
Bend, OR 97701-6099
Phone
(541) 382-4900
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2004032538 MO
Neurology Physician 2084N0400X MD212800 OR Primary

Addresses

Primary practice location

1501 NE Medical Center Dr
Bend, OR 97701-6099

Mailing address

PO Box 6048
Bend, OR 97708-6048
Phone (541) 382-4900

Other practice location 1

1020 Hitt St
Columbia, MO 65212-0001
Phone (573) 882-1515

Other identifiers 4

IdentifierTypeStateIssuer
P00415742OtherMORAILROAD MEDICARE
209425503MedicaidMO
500812704MedicaidOR
P00223849OtherMORR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address trolan19707@directmsg.bmctotalcare.com Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221118002398 OR Practitioner - Neurology 7315831401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Texas Tech University Health Science Center School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bend Memorial Clinic PCGroup PAC ID 7214936533, 225 clinicians

Practice addresses (Care Compare)

1501 NE Medical Ctr Dr
Bend, OR 97701-6051
Phone (541) 382-2811

Hospital & facility affiliations

  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047
  • St Charles Medical Center Prineville Hospital, Prineville, OR, CCN 381313

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Memorial Clinic PC Neurology Current Accepting new patients
Bend Memorial Clinic PC CurrentSince Jan 1, 2023 Accepting new patients
New Mexico Brain Institute, Inc. Neurology PastSince Sep 15, 2002 Accepting new patients

Locations

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

Networks

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

Interoperability endpoints

  • Direct secure messaging: trolan19707@directmsg.bmctotalcare.com

Organizations & group practices 3

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 3

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1063479103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6048",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086048",
            "telephone_number": "541-382-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016099",
            "telephone_number": "541-382-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 Hitt St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652120001",
            "country_code": "US",
            "telephone_number": "573-882-1515",
            "fax_number": "573-884-0070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLAN",
        "first_name": "TERRY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2004032538",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD212800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00415742",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209425503",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500812704",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00223849",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trolan19707@directmsg.bmctotalcare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1501 NE Medical Center Dr",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.