NPIMap

Organization Active NPI

Ortc, LLC

  • Substance Abuse Rehabilitation Facility
  • Bend, OR
National Provider Identifier
1154722361
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
RO0467034 Issued in OR
Legal business name
ORTC, LLC
Practice address
155 NE Revere Ave
Bend, OR 97701-4147
Phone
(541) 617-4544
Fax
(541) 385-4755
NPI assigned
Sep 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Matt Owen
Title
Owner
Phone
(541) 617-4544

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X
Substance Abuse Rehabilitation Facility 324500000X RO0467034 OR Primary

Addresses

Primary practice location

155 NE Revere Ave
Bend, OR 97701-4147

Mailing address

155 NE Revere Ave
Bend, OR 97701-4147
Phone (541) 617-4544

Other identifiers 1

IdentifierTypeStateIssuer
38D2081354OtherCLIA

Other names 1

  • Bend Treatment Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191218000584 OR Part B Supplier - Opioid Treatment Program (Otp) 6608200027 Practice locations: Bend, OR

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2081354Ortc LLC Dba Bend Treatment Center155 NE Revere Suite 150, Bend, OR 97701Certificate of waiverJul 22, 2028

National Provider Directory

National Provider Directory
Tax ID family
Grants Pass Treatment Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

155 NE Revere Ave
Bend, OR 97701
Phone (458) 206-5982

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1410048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1154722361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 NE REVERE AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014147",
            "telephone_number": "541-617-4544",
            "fax_number": "541-385-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 NE REVERE AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014147",
            "telephone_number": "541-617-4544",
            "fax_number": "541-385-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-07",
        "last_updated": "2023-03-07",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-617-4544",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "OR",
            "license": "RO0467034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "38D2081354",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bend Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bend Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.