Organization Active NPI

Alpenaura Plastic Surgery

  • Plastic Surgery Physician
  • Bend, OR
National Provider Identifier
1245058114
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
ALPENAURA PLASTIC SURGERY
Practice address
2275 NE Doctors Dr Ste 1
Bend, OR 97701-6324
Phone
(541) 762-0262
NPI assigned
Sep 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Authorized official

Name
Dr. Jourdan Ariss Carboy, MDNPI 1174027783
Title
Physician Business Owner
Phone
(541) 762-0262

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

2275 NE Doctors Dr Ste 1
Bend, OR 97701-6324

Mailing address

1382 NE Drost Dr
Bend, OR 97701-3707
Phone (214) 802-8297

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250205003556 OR Part B Supplier - Clinic/Group Practice 0042740037 Receives reassigned benefits from 1 practitioner
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1245058114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1382 NE DROST DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013707",
            "telephone_number": "214-802-8297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 NE DOCTORS DR STE 1",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016324",
            "telephone_number": "541-762-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPENAURA PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-30",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "CARBOY",
        "authorized_official_first_name": "JOURDAN",
        "authorized_official_middle_name": "ARISS",
        "authorized_official_title_or_position": "PHYSICIAN BUSINESS OWNER",
        "authorized_official_telephone_number": "541-762-0262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "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 Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.