Christopher Brice Bouffard, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA209384 Issued in OR

Practice address

1698 E McAndrews Rd Ste 160
Medford, OR 97504-5590

Phone

(541) 732-7874

NPI assigned

Feb 14, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services OregonGroup PAC ID 5294623245, 166 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Medford Medical Center Hospital, Medford, OR, CCN 380075

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbouffard2354398@oc.providencedirect.org

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.

• Providence Health & Services Oregon

  dba Providence Medical Group South

  • Family Medicine Physician
  • Medford, OR
  • NPI 1568547503
  Medicare reassignment Care Compare group
• Providence Health & Services - Oregon

  dba Providence Medford Medical Center

  • Clinic/Center
  • Medford, OR
  • NPI 1093976243
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  dba Providence Medford Medical Center

  • Clinical Pathology Physician
  • Medford, OR
  • NPI 1285185942
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group South

  • Family Medicine Physician
  • Medford, OR
  • NPI 1346619467
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group South

  • Clinic/Center
  • Phoenix, OR
  • NPI 1992882500
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group South

  • Internal Medicine Physician
  • Central Point, OR
  • NPI 1609951649
  NPD (past)
• Providence Health & Services - Oregon

  dba Providence Medford Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1689755670
  NPD (past)

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

• Providence Health & Services - Oregon

  dba Providence Medford Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1689755670
  Care Compare affiliation

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1073268561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "541-732-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 E MCANDREWS RD STE 160",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045590",
            "telephone_number": "541-732-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUFFARD",
        "first_name": "CHRISTOPHER",
        "middle_name": "BRICE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA209384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keyan Botsford, DMD, MSD
• Cindy Marie Bottasso, DO
• Sarah Katherine Bottomly-Cox
• Janeice K Bouchard
• Jennifer Katharine Boudreaux, MSN, CPNP-PC, PMHS
• Lydia Bouman
• Melissa Jean Bouse
• Alice Bowen, PT
• Kathy Bowlin, PT
• Judit Nemeth Bowling, PHD

• Surgical Physician Assistant in Medford, OR
• Providers in Medford, OR by specialty
• Surgical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.