Individual provider Active NPI

Seymour Maynard Bronstein, M.D.

  • Hematology & Oncology Physician
  • La Grande, OR
National Provider Identifier
1114984424
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD27924 Issued in OR
Practice address
900 Sunset Dr
La Grande, OR 97850-1387
Phone
(541) 963-2828
Fax
(541) 975-5132
NPI assigned
Apr 28, 2006
Last updated
Jan 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MD27924 OR Primary

Addresses

Primary practice location

900 Sunset Dr
La Grande, OR 97850-1387

Mailing address

900 Sunset Dr
La Grande, OR 97850-1387
Phone (541) 963-2828

Other identifiers 1

IdentifierTypeStateIssuer
12758MedicaidND

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
I20071226000097 OR Practitioner - Hematology/Oncology 8224935382 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grande Ronde Hospital, Inc. CurrentSince Sep 6, 2011 Accepting new patients
Wallowa County Health Care District CurrentSince Jun 2, 2025 Accepting new patients
Wallowa County Health Care District CurrentSince Jun 2, 2025 Accepting new patients
Grande Ronde Hospital, Inc. Current Accepting new patients
Grande Ronde Hospital, Inc CurrentSince Sep 6, 2011 Accepting new patients

Locations

601 Medical Pkwy
Enterprise, OR 97828
Phone (541) 426-3111

900 Sunset Dr
La Grande, OR 97850
Phone (541) 963-8421

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1114984424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 SUNSET DR",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501387",
            "telephone_number": "541-963-2828",
            "fax_number": "541-975-5132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SUNSET DR",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501387",
            "telephone_number": "541-963-2828",
            "fax_number": "541-975-5132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONSTEIN",
        "first_name": "SEYMOUR",
        "middle_name": "MAYNARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OR",
            "license": "MD27924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12758",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

Verify at the official NPI Registry.