Eric J Wattenburg, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD29323 Issued in OR

Practice address

3818 SW 21St St
Redmond, OR 97756

Phone

(541) 548-2899

Fax

(541) 504-3781

NPI assigned

Feb 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA, ID2 enrollments

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 2

Specialty

Family PracticeAlso: Emergency Medicine

Education

University of Nevada School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seneca Healthcare DistrictGroup PAC ID 8820907140, shared by 3 NPIs, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Seneca District Hospital Hospital, Chester, CA, CCN 051327

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Saint Alphonsus Medical Center- Ontario Inc

  • Internal Medicine Physician
  • Ontario, OR
  • NPI 1093034159

  ID

  Medicare reassignment NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychologist
  • Boise, ID
  • NPI 1649357716
  Medicare reassignment NPD
• Seneca Healthcare District

  • Medicare Defined Swing Bed Hospital Unit
  • Chester, CA
  • NPI 1326234022
  Medicare reassignment NPD
• Seneca Healthcare District

  • Critical Access Hospital
  • Chester, CA
  • NPI 1396848677
  Medicare reassignment NPD
• Saint Alphonsus Medical Center- Ontario Inc

  • General Acute Care Hospital
  • Ontario, OR
  • NPI 1891891792
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychiatric Hospital Unit
  • Boise, ID
  • NPI 1770687857
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • Family Medicine Physician
  • Caldwell, ID
  • NPI 1861676298
  NPD
• Icco, LLC

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  NPD (past)
• Marshall Group LLC

  • Urgent Care Clinic/Center
  • McMinnville, OR
  • NPI 1568609873
  NPD (past)
• Redmond Immediate Health Care LLC

  • Urgent Care Clinic/Center
  • Redmond, OR
  • NPI 1437187614
  NPD (past)
• East Tennessee Medical Group, PC

  • Family Medicine Physician
  • Alcoa, TN
  • NPI 1942238902
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Seneca Healthcare District

  • Critical Access Hospital
  • Chester, CA
  • NPI 1215116629
  Care Compare affiliation
• Seneca Healthcare District

  • Critical Access Hospital
  • Chester, CA
  • NPI 1396848677
  Care Compare affiliation

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1194791640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4858",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084858",
            "telephone_number": "541-500-2500",
            "fax_number": "541-500-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3818 SW 21ST ST",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "97756",
            "telephone_number": "541-548-2899",
            "fax_number": "541-504-3781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6051 W Emerald St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837048969",
            "country_code": "US",
            "telephone_number": "208-302-5150",
            "fax_number": "208-302-5155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTENBURG",
        "first_name": "ERIC",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A78764",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD29323",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD29323",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "6761572",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "00887743",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500608820",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOA787640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hanxiang Alex Wang, MD
• Water Cup Counseling
• Donna Lynn Watkins
• Marilyn Joanne Watkins, RN
• Rachel Watkins
• Megan Rae Weaver
• Haley Webb, MS, OTR/L
• Amanda Wade Weiland, FNP
• Alayna Weimer
• Courtney Dawn Welch, MS SLP

• Family Medicine Physician in Redmond, OR
• Providers in Redmond, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.