NPIMap

Individual provider Active NPI

Jeremy S Bedtelyon, MD

  • Internal Medicine Physician
  • Albany, OR
National Provider Identifier
1235340605
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD29330 Issued in OR
Practice address
1046 6TH Ave SW
Albany, OR 97321-1916
Phone
(541) 967-4249
Fax
(541) 928-2942
NPI assigned
May 25, 2007
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 82687 MT
Internal Medicine Physician 207R00000X MD29330 OR Primary
Pediatrics Physician 208000000X MD29330 OR

Addresses

Primary practice location

1046 6TH Ave SW
Albany, OR 97321-1916

Mailing address

1046 6TH Ave SW
Albany, OR 97321-1916
Phone (541) 967-4249

Other practice location 1

310 Sunnyview Ln
Kalispell, MT 59901-3129
Phone (406) 751-5310

Other identifiers 1

IdentifierTypeStateIssuer
500608443MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200601001198 MT Practitioner - Internal Medicine 1153475892 Reassigns benefits to 3 organizations
I20210623002553 MI Practitioner - Internal Medicine 1153475892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Logan Health - WhitefishGroup PAC ID 9335033687, 48 clinicians
Memorial HospitalGroup PAC ID 8527976497, 210 clinicians

Practice addresses (Care Compare)

1600 Hospital Way
Whitefish, MT 59937-7849
Phone (406) 863-3500

310 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 751-6488

826 W King St
Memorial Medical Associates
Owosso, MI 48867-2120
Phone (989) 723-5211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82687MTMDInternal Medicine Physician
MD29330ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kalispell Regional Medical Center, Inc CurrentSince Jun 30, 2020 Accepting new patients
Logan Health - Whitefish CurrentSince Jun 2, 2024 Accepting new patients
Memorial Hospital Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Logan Health - Whitefish CurrentSince Jun 2, 2024 Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Glacier Regional Pathology, LTD. Current Accepting new patients
Memorial Hospital CurrentSince Jul 1, 2021 Accepting new patients
Kalispell Regional Medical Center Inc CurrentSince Jun 30, 2020 Accepting new patients
Memorial Hospital Past Accepting new patients
Logan Health - Whitefish Past Accepting new patients
Logan Health - Whitefish Past Accepting new patients
Good Samaritan Hospital Corvallis Past Accepting new patients
Firstcare Medical Foundation Internal Medicine PastSince Sep 1, 2004 Accepting new patients

Locations

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

1975 W M 21
Ste 103
Owosso, MI 48867

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

75 Claremont St
Ste H
Kalispell, MT 59901
Phone (406) 752-7406

1600 Hospital Way
Whitefish, MT 59937
Phone (406) 863-3500

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 9

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1235340605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 6TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211916",
            "telephone_number": "541-967-4249",
            "fax_number": "541-928-2942"
        },
        {
            "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": "541-967-4249",
            "fax_number": "541-928-2942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Sunnyview Ln",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013129",
            "country_code": "US",
            "telephone_number": "406-751-5310",
            "fax_number": "406-751-3068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEDTELYON",
        "first_name": "JEREMY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "82687",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD29330",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD29330",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500608443",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "310 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.