Individual provider Active NPI

Michael Patrick Bartell, D.C.

  • Chiropractor
  • North Bend, OR
National Provider Identifier
1184720229
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5921 Issued in OR
Practice address
400 Virginia Ave Ste 114
North Bend, OR 97459-3477
Phone
(541) 808-9697
Fax
(541) 808-9699
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHR0006933 CO
Chiropractor 111N00000X 038-007339 IL
Chiropractor 111N00000X 5921 OR Primary

Addresses

Primary practice location

400 Virginia Ave Ste 114
North Bend, OR 97459-3477

Mailing address

400 Virginia Ave Ste 114
North Bend, OR 97459-3477
Phone (630) 205-9000

Other identifiers 1

IdentifierTypeStateIssuer
4527478OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181016000198 OR Practitioner - Chiropractic 3476522764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2182 Broadway Ave
North Bend, OR 97459-2330

50219 Hwy 101
Bandon, OR 97411-8242
Phone (630) 205-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHR0006933COMDChiropractor
038-007339ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Rehabilitation Associates, Inc. Chiropractor PastSince Nov 1, 2004 Accepting new patients
Dupage Health and Wellness Centers, LTD Chiropractor PastSince Nov 13, 2002 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1184720229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 VIRGINIA AVE STE 114",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593477",
            "telephone_number": "630-205-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 VIRGINIA AVE STE 114",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593477",
            "telephone_number": "541-808-9697",
            "fax_number": "541-808-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTELL",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR0006933",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-007339",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4527478",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.