Individual provider Active NPI

Mariah Weigel, PA-C

  • Physician Assistant
  • Bend, OR
National Provider Identifier
1164916946
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA208184 Issued in OR
Practice address
1501 NE Medical Center Dr
Bend, OR 97701-6099
Phone
(541) 382-4900
NPI assigned
Jun 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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 PA208184 OR Primary

Addresses

Primary practice location

1501 NE Medical Center Dr
Bend, OR 97701-6099

Mailing address

PO Box 6048
Bend, OR 97708-6048
Phone (541) 382-4900

Other practice location 1

2635 N 7th St
Grand Junction, CO 81501-8209
Phone (970) 298-2273

Other identifiers 1

IdentifierTypeStateIssuer
500803288MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mweigel20272@directmsg.bmctotalcare.com Direct

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
I20220422001890 OR Practitioner - Physician Assistant 5193079804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bend Memorial Clinic PCGroup PAC ID 7214936533, 225 clinicians

Practice addresses (Care Compare)

1501 NE Medical Ctr Dr
Bend, OR 97701-6051
Phone (541) 382-2811

333 NW Larch Ave
Suite 2
Redmond, OR 97756-1186
Phone (541) 382-4900

815 SW Bond St
Bend, OR 97702-3593

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA208184ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Memorial Clinic PC CurrentSince Jul 1, 2023 Accepting new patients
Bend Memorial Clinic PC Physician Assistant Past Accepting new patients

Locations

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

815 SW Bond St
Bend, OR 97702
Phone (541) 382-4900

Interoperability endpoints

  • Direct secure messaging: mweigel20272@directmsg.bmctotalcare.com

Organizations & group practices 3

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": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1164916946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6048",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086048",
            "telephone_number": "541-382-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016099",
            "telephone_number": "541-382-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2635 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815018209",
            "country_code": "US",
            "telephone_number": "970-298-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIGEL",
        "first_name": "MARIAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA208184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500803288",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mweigel20272@directmsg.bmctotalcare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1501 NE Medical Center Dr",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.