Individual provider Active NPI

Roza Saitlin Pacifico, NP

  • Women's Health Nurse Practitioner
  • Redmond, OR
National Provider Identifier
1104144427
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
201502927NP Issued in OR
Practice address
340 NW 5TH St Ste 101
Redmond, OR 97756-1869
Phone
(541) 526-6635
Fax
(541) 526-6636
NPI assigned
May 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201502926RN OR
Women's Health Nurse Practitioner 363LW0102X 201502927NP OR Primary

Addresses

Primary practice location

340 NW 5TH St Ste 101
Redmond, OR 97756-1869

Mailing address

PO Box 5579
Bend, OR 97708-5579
Phone (541) 706-5920

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rpacifico17896@secure.stcharleshealthcare.org

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
I20160105001392 OR Practitioner - Nurse Practitioner 2860688447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Mercer University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164

2600 NE Neff Rd
SCMG Imaging
Bend, OR 97701-6337
Phone (541) 706-4905

340 NW 5TH St
101 Cent Women HT
Redmond, OR 97756-1869
Phone (541) 526-6635

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201502927NPORMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Nov 1, 2015 Accepting new patients
St. Charles Health System, Inc. CurrentSince Nov 1, 2015 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

1885 NE Purcell Blvd
Bend, OR 97701
Phone (541) 322-2700

340 NW 5th St
Ste 101
Redmond, OR 97756
Phone (734) 545-3348

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

Organizations & group practices 2

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 2

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": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1104144427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5579",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977085579",
            "telephone_number": "541-706-5920",
            "fax_number": "541-706-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 NW 5TH ST STE 101",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561869",
            "telephone_number": "541-526-6635",
            "fax_number": "541-526-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACIFICO",
        "first_name": "ROZA",
        "middle_name": "SAITLIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-11",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201502926RN",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "201502927NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpacifico17896@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "340 NW 5th St Ste 101",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977561869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.