NPIMap

Individual provider Active NPI

Hadjer Bounama

  • Family Medicine Physician
  • Lebanon, OR
National Provider Identifier
1245649474
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO218800 Issued in OR
Practice address
191 N Main St
Lebanon, OR 97355-2870
Phone
(541) 451-7940
NPI assigned
Aug 13, 2014
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X UO5384 FL
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X DO218800 OR Primary

Addresses

Primary practice location

191 N Main St
Lebanon, OR 97355-2870

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

6450 38th Ave N
St Petersburg, FL 33710-1645
Phone (727) 545-4444

Other practice location 2

500 NE Multnomah St # 16
Portland, OR 97232-2023
Phone (503) 813-1085

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hbounama291327@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 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
I20200902000848 CA Practitioner - Family Practice 4688091820 Reassigns benefits to 3 organizations
I20240426001327 OR Practitioner - Family Practice 4688091820 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Col of Osteo Med of the Pacific at Lebanon, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Valley Healthcare IncGroup PAC ID 2769391523, 143 clinicians

Practice addresses (Care Compare)

191 N Main St
Lebanon, OR 97355-2870
Phone (541) 451-7940

646 Holley Rd
Sweet Home, OR 97386-3344
Phone (541) 451-6272

679 Main St
Sweet Home, OR 97386-3305
Phone (541) 451-6250

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.77 of 100Reported as group
Quality
88.09
Promoting interoperability
100
Improvement activities
40
Cost
84.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17981CAMDDental Hygienist
UO5384FLMDFamily Medicine Physician
DO218800ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Aug 25, 2020 Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince May 1, 2024 Accepting new patients
County of Santa Clara CurrentSince Aug 25, 2020 Accepting new patients
County of Santa Clara Family Medicine Current Accepting new patients
County of Santa Clara CurrentSince Aug 25, 2020 Accepting new patients
Mid-Valley Healthcare Inc Current Accepting new patients
County of Santa Clara Current Accepting new patients
Mid-Valley Healthcare Inc CurrentSince May 1, 2024 Accepting new patients
County of Santa Clara CurrentSince Aug 25, 2020 Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

191 N Main St
Lebanon, OR 97355
Phone (541) 451-7940

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

Interoperability endpoints

  • Direct secure messaging: hbounama291327@samhealth.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 55

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

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1245649474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 N MAIN ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973552870",
            "telephone_number": "541-451-7940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6450 38th Ave N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337101645",
            "country_code": "US",
            "telephone_number": "727-545-4444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 NE Multnomah St # 16",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972322023",
            "country_code": "US",
            "telephone_number": "503-813-1085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUNAMA",
        "first_name": "HADJER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-13",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "UO5384",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO218800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hbounama291327@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "191 N Main St",
            "city": "Lebanon",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973552870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

Verify at the official NPI Registry.