NPIMap

Individual provider Active NPI

Patrick Joseph Phelan, M.D.

  • Surgery Physician
  • Medford, OR
National Provider Identifier
1144412529
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD177180 Issued in OR
Practice address
520 Medical Center Dr
Ste 300
Medford, OR 97504-4316
Phone
(541) 930-8907
Fax
(541) 245-4820
NPI assigned
Aug 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ML20009072 WA
Surgery Physician 208600000X MD177180 OR Primary
Vascular Surgery Physician 2086S0129X MD177180 OR

Addresses

Primary practice location

520 Medical Center Dr
Ste 300
Medford, OR 97504-4316

Mailing address

520 Medical Center Dr
Ste 300
Medford, OR 97504-4316
Phone (541) 930-8907

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160819000516 OR Practitioner - Vascular SurgeryPractitioner - General Surgery 7113236076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Emory University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oregon Surgical Specialists PCGroup PAC ID 4789589540, 21 clinicians

Practice addresses (Care Compare)

520 Medical Ctr Dr
Suite 300
Medford, OR 97504-4316
Phone (541) 930-8907

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)12
Varicose vein removal31
Melanoma (skin cancer) excision1-10
Leg revascularization (restoring blood flow)34
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD177180ORMDSurgery Physician
ML20009072WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Surgical Specialists PC Surgery CurrentSince Aug 1, 2016 Accepting new patients

Locations

520 Medical Center Dr
Ste 300
Medford, OR 97504
Phone (503) 779-0837

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

Interoperability endpoints

  • Direct secure messaging: patrickphelan@osspc.allscriptsdirect.net

Organizations & group practices 1

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 7

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": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1144412529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR",
            "address_2": "STE 300",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044316",
            "telephone_number": "541-930-8907",
            "fax_number": "541-245-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR",
            "address_2": "STE 300",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044316",
            "telephone_number": "541-930-8907",
            "fax_number": "541-245-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "PATRICK",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "ML20009072",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD177180",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OR",
            "license": "MD177180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.