Individual provider Active NPI

Rainie A Rogers, PA C

  • Physician Assistant
  • Bend, OR
National Provider Identifier
1154312627
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01217 Issued in OR
Practice address
1303 NE Cushing Dr
Suite 100
Bend, OR 97701-3887
Phone
(541) 388-2333
Fax
(541) 330-8230
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01217 OR Primary

Addresses

Primary practice location

1303 NE Cushing Dr
Suite 100
Bend, OR 97701-3887

Mailing address

1303 NE Cushing Dr
Suite 100
Bend, OR 97701-3887
Phone (541) 388-2333

Other identifiers 2

IdentifierTypeStateIssuer
000000352912OtherANTHEM
7009628OtherAETNA

Other names 1

  • Rainie A Rogers Other name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080123000308 OR Practitioner - Physician Assistant 7810957081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1900 Main St
Suite a
Klamath Falls, OR 97601-2629
Phone (541) 382-5712

2747 NE Conners Ave
Bend, OR 97701-8738
Phone (541) 382-5712

2855 NW Crossing Dr
Suite 104
Bend, OR 97703-7049
Phone (541) 382-5712

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Dermatology Clinic LLC Current Accepting new patients
Mountain West Derm - Blackhart PLLC CurrentSince Dec 1, 2024 Accepting new patients
Physicians of Central Oregon, LLC Past Accepting new patients
Mountain West Derm - Blackhart PLLC Past Accepting new patients

Locations

640 W Moana Ln
Reno, NV 89509
Phone (775) 882-8777

2747 NE Conners Ave
Bend, OR 97701
Phone (541) 322-1980

Interoperability endpoints

  • Direct secure messaging: rrogers@skincancerderm.emadirect.md

Organizations & group practices 4

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1154312627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 NE CUSHING DR",
            "address_2": "SUITE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013887",
            "telephone_number": "541-388-2333",
            "fax_number": "541-330-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 NE CUSHING DR",
            "address_2": "SUITE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013887",
            "telephone_number": "541-388-2333",
            "fax_number": "541-330-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "RAINIE",
        "middle_name": "A",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000352912",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7009628",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAINIE",
            "last_name": "ROGERS",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.