Individual provider Active NPI

Jane Corboy, MD

  • Family Medicine Physician
  • The Dalles, OR
National Provider Identifier
1235219676
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD150490 Issued in OR
Practice address
1620 E 12TH St
The Dalles, OR 97058-3213
Phone
(541) 296-9151
Fax
(541) 296-9156
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G3248 TX
Family Medicine Physician 207Q00000X MD150490 OR Primary

Addresses

Primary practice location

1620 E 12TH St
The Dalles, OR 97058-3213

Mailing address

1620 E 12TH St
PO Box 1520
The Dalles, OR 97058-3213
Phone (541) 296-9151

Other identifiers 3

IdentifierTypeStateIssuer
137841611MedicaidTX
137841605MedicaidTX
218112MedicaidOR

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
I20140927000149 OR Practitioner - Family Practice 0143415075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Columbia Medical CenterGroup PAC ID 3779487251, 99 clinicians

Practice addresses (Care Compare)

PO Box
The Dalles, OR 97058

Hospital & facility affiliations

  • Adventist Health Home Care Home health agency, The Dalles, OR, CCN 387041
  • Mid-Columbia Medical Center Hospital, The Dalles, OR, CCN 380001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD150490ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Medical Center CurrentSince Nov 1, 2014 Accepting new patients
Mid-Columbia Medical Center Family Medicine CurrentSince Nov 1, 2014 Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients
Baylor College of Medicine Past Accepting new patients

Locations

1620 E 12th St
The Dalles, OR 97058
Phone (541) 296-9151

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

1810 E 19th St
Ste 209
The Dalles, OR 97058
Phone (541) 296-5657

551 Lone Pine Blvd
The Dalles, OR 97058
Phone (541) 296-7202

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

1810 E 19th St
Ste 211
The Dalles, OR 97058
Phone (503) 292-1400

Interoperability endpoints

  • Direct secure messaging: jcorboy89361@direct.ohsu.edu

Organizations & group practices 5

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 2

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1235219676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 E 12TH ST",
            "address_2": "PO BOX 1520",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583213",
            "telephone_number": "541-296-9151",
            "fax_number": "541-296-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E 12TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583213",
            "telephone_number": "541-296-9151",
            "fax_number": "541-296-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBOY",
        "first_name": "JANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G3248",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD150490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137841611",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137841605",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218112",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Dalles, OR

Sources for this page

Verify at the official NPI Registry.