Juniper Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

JUNIPER DERMATOLOGY LLC

Practice address

2450 NE Mary Rose PL Ste 201
Bend, OR 97701-7133

Phone

(541) 585-7546

Fax

(541) 582-7177

NPI assigned

Aug 5, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Karla Pivik, DONPI 1417207283

Title

Authorized Official

Phone

(541) 647-9634

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karla S Pivik, D.O.

  • Dermatology Physician
  • Bend, OR
  • NPI 1417207283
  Medicare reassignment Care Compare group NPD Authorized official
• Matthew Dean Firebaugh, PA-C

  • Physician Assistant
  • Bend, OR
  • NPI 1598019747
  Medicare reassignment Care Compare group
• Dacia Renee Kailin, PA-C

  • Medical Physician Assistant
  • Bend, OR
  • NPI 1770282055
  Medicare reassignment Care Compare group
• Elena Evelyn Salpas, PA-C

  • Physician Assistant
  • Bend, OR
  • NPI 1518448463
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1134856404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 NE MARY ROSE PL STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017133",
            "telephone_number": "541-585-7546",
            "fax_number": "541-582-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 NE MARY ROSE PL STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017133",
            "telephone_number": "541-585-7546",
            "fax_number": "541-582-7177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 NW Larch Ave",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977561992",
            "country_code": "US",
            "telephone_number": "541-585-7546",
            "fax_number": "541-582-7177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JUNIPER DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-05",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "PIVIK",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "541-647-9634",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY CODE",
            "identifier": "193400000X",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "juniperdermatology.ema.md",
            "affiliation": "N",
            "endpointDescription": "URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2239 NE Doctors Drive",
            "address_2": "Ste 100",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Dermatology Physician in Bend, OR
• Providers in Bend, OR by specialty
• Dermatology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.