Individual provider Active NPI

Barrett Jereme Woodhall, MD

  • Emergency Medicine Physician
  • Prineville, OR
National Provider Identifier
1174799902
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD28250 Issued in OR
Practice address
1201 NE Elm St
Prineville, OR 97754-1206
Phone
(541) 447-6254
NPI assigned
May 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD28250 OR Primary

Addresses

Primary practice location

1201 NE Elm St
Prineville, OR 97754-1206

Mailing address

3311 Indian Queen LN
Apt.#2
Philadelphia, PA 19129-1519
Phone (215) 908-6392

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bwoodhall126815@oc.providencedirect.org

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
I20080630000272 OR Practitioner - Emergency Medicine 8921170309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Ohio, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10150 SE 32ND Ave
Milwaukie, OR 97222-6516
Phone (503) 513-8300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.39 of 100Reported as group
Quality
83
Promoting interoperability
100
Improvement activities
40
Cost
89.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD28250ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Mar 7, 2010 Accepting new patients
Providence Health & Services Oregon Emergency Medicine CurrentSince Mar 7, 2010 Accepting new patients

Locations

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

Organizations & group practices 2

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 1

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": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1174799902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 INDIAN QUEEN LN",
            "address_2": "APT.#2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291519",
            "telephone_number": "215-908-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NE ELM ST",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541206",
            "telephone_number": "541-447-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODHALL",
        "first_name": "BARRETT",
        "middle_name": "JEREME",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-01",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD28250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwoodhall126815@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "10150 SE 32nd Ave",
            "city": "Milwaukie",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972226516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prineville, OR

Sources for this page

Verify at the official NPI Registry.