NPIMap

Individual provider Active NPI

Kathryn Caba, PA-C

  • Surgical Physician Assistant
  • Bend, OR
National Provider Identifier
1235405267
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA00787 Issued in OR
Practice address
1303 NE Cushing Dr
Ste 100
Bend, OR 97701-3887
Phone
(541) 330-8226
Fax
(541) 318-0373
NPI assigned
Mar 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA00787 OR Primary

Addresses

Primary practice location

1303 NE Cushing Dr
Ste 100
Bend, OR 97701-3887

Mailing address

1303 NE Cushing Dr
Ste 100
Bend, OR 97701-3887
Phone (541) 330-8226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ponderosa Medical Past Accepting new patients
Physicians of Central Oregon, LLC Past Accepting new patients

Organizations & group practices 2

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": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1235405267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 NE CUSHING DR",
            "address_2": "STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013887",
            "telephone_number": "541-330-8226",
            "fax_number": "541-318-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 NE CUSHING DR",
            "address_2": "STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013887",
            "telephone_number": "541-330-8226",
            "fax_number": "541-318-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABA",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA00787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.