Individual provider Active NPI

Blaine B. Rourke, DO

  • Emergency Medicine Physician
  • Albany, OR
National Provider Identifier
1184640740
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO217686 Issued in OR
Practice address
1046 6TH Ave SW
Albany, OR 97321-1916
Phone
(541) 812-4000
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO217686 OR Primary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA03254 TX

Addresses

Primary practice location

1046 6TH Ave SW
Albany, OR 97321-1916

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

809 82nd Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1752

Other practice location 2

400 9th St
Florence, OR 97439-7398
Phone (541) 997-8412

Other identifiers 2

IdentifierTypeStateIssuer
182196901MedicaidTX
8L5723OtherTXMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brourke268587@samhealth.direct-ci.com

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
I20240702004391 OR Practitioner - Emergency Medicine 8820078058 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.23
Promoting interoperability
100
Improvement activities
40
Cost
100

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
92.31
Promoting interoperability
100
Improvement activities
40
Cost
80.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Physician Assistant

State licenses

LicenseStateTypeSpecialty
DO217686ORMDEmergency Medicine Physician
PA03254TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Albany General Hospital CurrentSince Jul 1, 2024 Accepting new patients
Albany General Hospital CurrentSince Jul 1, 2024 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Jul 3, 2024 Accepting new patients
Peacehealth CurrentSince Apr 21, 2025 Accepting new patients
Albany General Hospital Current Accepting new patients
Samaritan North Lincoln Hospital Current Accepting new patients
Peacehealth Current Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Jul 3, 2024 Accepting new patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients

Locations

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

1046 6th Ave SW
Albany, OR 97321
Phone (541) 812-4000

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

400 9th St
Florence, OR 97439
Phone (541) 997-8412

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

Interoperability endpoints

  • Direct secure messaging: brourke732354@direct.peacehealth.org

Organizations & group practices 9

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1184640740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 6TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211916",
            "telephone_number": "541-812-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 82nd Pkwy",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295724607",
            "country_code": "US",
            "telephone_number": "843-692-1752",
            "fax_number": "843-692-1904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 9th St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "OR",
            "postal_code": "974397398",
            "country_code": "US",
            "telephone_number": "541-997-8412",
            "fax_number": "541-902-1695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROURKE",
        "first_name": "BLAINE",
        "middle_name": "B.",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "DO217686",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03254",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182196901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "8L5723",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brourke268587@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1046 6th Ave SW",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.