Individual provider Active NPI

James Michael Carlson, DO

  • Obstetrics & Gynecology Physician
  • Bend, OR
National Provider Identifier
1104800994
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
DO23967 Issued in OR
Practice address
2400 NE Neff Rd
Ste a
Bend, OR 97701-6752
Phone
(541) 389-3300
Fax
(541) 389-8115
NPI assigned
Dec 5, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X DO23967 OR Primary

Addresses

Primary practice location

2400 NE Neff Rd
Ste a
Bend, OR 97701-6752

Mailing address

2400 NE Neff Rd
Ste a
Bend, OR 97701-6752
Phone (541) 389-3300

Other identifiers 1

IdentifierTypeStateIssuer
286583MedicaidOR

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
I20080129000570 OR Practitioner - Obstetrics/Gynecology 3577645514 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Cascade Womens Group P CGroup PAC ID 9638166796, 18 clinicians

Practice addresses (Care Compare)

2400 NE Neff Rd
Suite a
Bend, OR 97701-6752
Phone (541) 389-3300

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Oregon PC Obstetrics & Gynecology CurrentSince Sep 1, 2019 Accepting new patients
East Cascade Womens Group, P C Obstetrics & Gynecology CurrentSince Jul 1, 2013 Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients
St. Charles Health System, Inc. PastSince Jul 1, 2013 Accepting new patients

Locations

2400 NE Neff Rd
Ste A
Bend, OR 97701
Phone (541) 389-3300

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

Interoperability endpoints

  • Direct secure messaging: jcarlson24463@coipa.gardenplot.direct-ci.com
  • FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/ECWG/api/FHIR/R4

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 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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1104800994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 NE NEFF RD",
            "address_2": "STE A",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016752",
            "telephone_number": "541-389-3300",
            "fax_number": "541-389-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NE NEFF RD",
            "address_2": "STE A",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016752",
            "telephone_number": "541-389-3300",
            "fax_number": "541-389-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "DO23967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286583",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.