Individual provider Active NPI

Russell Shepherd Lewis Jr., M.D.

  • Hematology & Oncology Physician
  • Bend, OR
National Provider Identifier
1104273382
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD208093 Issued in OR
Practice address
2500 NE Neff Rd
Bend, OR 97701-6015
Phone
(541) 706-5911
Fax
(541) 706-2645
NPI assigned
May 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hematology & Oncology Physician 207RH0003X MD208093 OR Primary

Addresses

Primary practice location

2500 NE Neff Rd
Bend, OR 97701-6015

Mailing address

60959 Snowberry PL
Bend, OR 97702-9182

Other practice location 1

15 York St
YNHH Dept of Medicine, LMP 1092
New Haven, CT 06510-3221
Phone (203) 688-5555

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rlewis196345@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220707002198 OR Practitioner - Hematology/OncologyPractitioner - Internal Medicine 1355635038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

1541 NW Canal Blvd
Cancer Cent
Redmond, OR 97756-1341
Phone (541) 706-5800

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

2500 NE Neff Rd
Bend, OR 97701-6015

51781 Huntington Rd
La Pine, OR 97739-1118
Phone (541) 666-7920

Hospital & facility affiliations

  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047
  • St Charles Medical Center Prineville Hospital, Prineville, OR, CCN 381313
  • Harney District Hospital Hospital, Burns, OR, CCN 381307
  • St Charles Madras Hospital, Madras, OR, CCN 381324
  • Blue Mountain Hospital Hospital, John Day, OR, CCN 381305

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince May 28, 2024 Accepting new patients
St. Charles Health System, Inc. CurrentSince May 28, 2024 Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients
Oregon Oncology Specialists, LLP Hematology & Oncology Past Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

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

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

Organizations & group practices 4

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 7

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": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1104273382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60959 SNOWBERRY PL",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977029182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016015",
            "telephone_number": "541-706-5911",
            "fax_number": "541-706-2645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 York St",
            "address_2": "YNHH Dept of Medicine, LMP 1092",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103221",
            "country_code": "US",
            "telephone_number": "203-688-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "RUSSELL",
        "middle_name": "SHEPHERD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-18",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OR",
            "license": "MD208093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlewis196345@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2500 NE Neff Rd",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.