NPIMap

Individual provider Active NPI

Klarissa N Beller, M.D.

  • Internal Medicine Physician
  • Eugene, OR
National Provider Identifier
1104898956
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD23800 Issued in OR
Practice address
1200 Hilyard St Ste 520a
Eugene, OR 97401-8122
Phone
(541) 687-6041
Fax
(541) 687-6009
NPI assigned
Feb 6, 2006
Last updated
Jan 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD23800 OR Primary

Addresses

Primary practice location

1200 Hilyard St Ste 520a
Eugene, OR 97401-8122

Mailing address

PO Box 24410
Eugene, OR 97402-0451

Other identifiers 1

IdentifierTypeStateIssuer
286635MedicaidOR

Other names 1

  • Klarissa K Nelson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210621001655 WY Practitioner - Internal Medicine 1951438175 Reassigns benefits to 1 organization
I20230530001148 MT Practitioner - Family Practice 1951438175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New Mexico School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 Westwood Dr
Hamilton, MT 59840-2345

1270 Westwood Dr
Hamilton, MT 59840-2345
Phone (406) 375-4758

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD23800ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evanston Hospital Corporation Current Accepting new patients
Marcus Daly Memorial Hospital Corporation CurrentSince May 1, 2023 Accepting new patients
Evanston Hospital Corporation CurrentSince Jul 1, 2021 Accepting new patients
Marcus Daly Memorial Hospital Corporation Current Accepting new patients
Marcus Daly Memorial Hospital Corporation CurrentSince May 1, 2023 Accepting new patients
Evanston Hospital Corporation CurrentSince Jul 1, 2021 Accepting new patients
Marcus Daly Memorial Hospital Corporation Current Accepting new patients
Discover Care Center Rehabilitation and Nursing LLC Past Accepting new patients

Locations

1200 Westwood Dr
Hamilton, MT 59840
Phone (406) 363-2211

1200 Westwood Dr
Ste I
Hamilton, MT 59840
Phone (406) 363-1100

1224 W Main St
Hamilton, MT 59840
Phone (406) 375-4823

3975 US Highway 93 N
Stevensville, MT 59870
Phone (406) 375-4824

190 Arrowhead Dr
Evanston, WY 82930
Phone (307) 789-3636

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1583/brand/2/csg/28/fhir/r4
  • Direct secure messaging: kbeller@yourcarecommunity.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1104898956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24410",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974020451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HILYARD ST STE 520A",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018122",
            "telephone_number": "541-687-6041",
            "fax_number": "541-687-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLER",
        "first_name": "KLARISSA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD23800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286635",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KLARISSA",
            "last_name": "NELSON",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.