Individual provider Active NPI

Jason Tavakolian, MD

  • Orthopaedic Surgery Physician
  • Eugene, OR
National Provider Identifier
1144220195
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD25760 Issued in OR
Practice address
55 Coburg Rd
Eugene, OR 97401-2433
Phone
(541) 485-8111
Fax
(541) 342-6379
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X MD25760 OR
Orthopaedic Surgery Physician 207X00000X MD25760 OR Primary

Addresses

Primary practice location

55 Coburg Rd
Eugene, OR 97401-2433

Mailing address

55 Coburg Rd
Eugene, OR 97401-2433
Phone (541) 485-8111

Other identifiers 2

IdentifierTypeStateIssuer
023191MedicaidOR
P00317978OtherORMC RAILROAD

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
I20050624000993 OR Practitioner - Orthopedic SurgeryPractitioner - Hand Surgery 9931144359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Hand Surgery
Education
Geisel School of Medicine at Dartmouth, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Slocum Orthopedics PCGroup PAC ID 0547164758, 67 clinicians

Practice addresses (Care Compare)

55 Coburg Rd
Eugene, OR 97401-2433
Phone (541) 485-8111

Hospital & facility affiliations

  • Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)52
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25760ORMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Slocum Orthopedics, PC Orthopaedic Surgery CurrentSince Jun 24, 2005 Accepting new patients
Slocum Orthopedics, PC Orthopaedic Surgery CurrentSince Jun 24, 2005 Accepting new patients

Locations

55 Coburg Rd
Eugene, OR 97401
Phone (541) 485-8111

Interoperability endpoints

  • Direct secure messaging: jtavakol@yourcarecommunity.org
  • Direct secure messaging: jason.tavakolian.p1@direct.slocumcenter.nextgenshare.com

Organizations & group practices 2

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1144220195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 COBURG RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012433",
            "telephone_number": "541-485-8111",
            "fax_number": "541-342-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 COBURG RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012433",
            "telephone_number": "541-485-8111",
            "fax_number": "541-342-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAKOLIAN",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "OR",
            "license": "MD25760",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD25760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023191",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC RAILROAD",
            "identifier": "P00317978",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.