Individual provider Active NPI

Michael Welch

  • Physician Assistant
  • Medford, OR
National Provider Identifier
1063802015
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA184897 Issued in OR
Practice address
691 Murphy Rd Ste 218
Medford, OR 97504-4311
Phone
(541) 789-4078
NPI assigned
Jan 29, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA184897 OR Primary
Physician Assistant 363A00000X PA9108511 FL

Addresses

Primary practice location

691 Murphy Rd Ste 218
Medford, OR 97504-4311

Mailing address

691 Murphy Rd Ste 218
Medford, OR 97504-4311
Phone (541) 789-4078

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171220001309 OR Practitioner - Physician Assistant 7113245580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

280 Maple St
Ashland, OR 97520-1552
Phone (541) 201-4000

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (541) 789-7000

500 SW Ramsey Ave
Grants Pass, OR 97527-5554
Phone (541) 472-7000

625 SW Ramsey Ave
Suite a
Grants Pass, OR 97527-5808
Phone (541) 507-2290

Hospital & facility affiliations

  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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 1

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": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1063802015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 MURPHY RD STE 218",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044311",
            "telephone_number": "541-789-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 MURPHY RD STE 218",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044311",
            "telephone_number": "541-789-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-29",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA184897",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.