Individual provider Active NPI

Eric Brian Smith, MD

  • Anesthesiology Physician
  • Bend, OR
National Provider Identifier
1174724652
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD27389 Issued in OR
Practice address
60507 Seventh Mountain Dr
Bend, OR 97702-1940
Phone
(541) 977-8501
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 57258 AZ
Anesthesiology Physician 207L00000X MD27389 OR Primary

Addresses

Primary practice location

60507 Seventh Mountain Dr
Bend, OR 97702-1940

Mailing address

60507 Seventh Mountain Dr
Bend, OR 97702-1940
Phone (541) 977-8501

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
I20070730000753 OR Practitioner - Anesthesiology 9537260849 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD27389ORMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Anesthesiology Group, PC Anesthesiology CurrentSince Jul 9, 2007 Accepting new patients

Locations

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

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.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1174724652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60507 SEVENTH MOUNTAIN DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021940",
            "telephone_number": "541-977-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60507 SEVENTH MOUNTAIN DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021940",
            "telephone_number": "541-977-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ERIC",
        "middle_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "57258",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD27389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.