Individual provider Active NPI

Noelle Dominique Vacchio-Caulley, PA-C

  • Physician Assistant
  • Bend, OR
National Provider Identifier
1265806053
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
174942 Issued in OR
Practice address
2042 NE Williamson CT
Bend, OR 97701-3760
Phone
(541) 706-6905
Fax
(541) 706-6906
NPI assigned
Nov 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 174942 OR Primary

Addresses

Primary practice location

2042 NE Williamson CT
Bend, OR 97701-3760

Mailing address

723 71St St
Springfield, OR 97478-4205
Phone (541) 968-6676

Other practice location 1

3311 Riverbend Dr
Suite 300
Springfield, OR 97477-8800
Phone (541) 968-6676

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nvacchiocaulley84449@secure.stcharleshealthcare.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151214001587 OR Practitioner - Physician Assistant 5294036455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

1253 NW Canal Blvd
Adv Illness Manag
Redmond, OR 97756-1334
Phone (541) 706-5880

2042 NE Williamson CT
Sleep Cent
Bend, OR 97701-3760
Phone (541) 706-6905

211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164

655 NW Jackpine Ave
Sleep Cent
Redmond, OR 97756-1334
Phone (541) 526-6661

Hospital & facility affiliations

  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
174942ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Nov 5, 2018 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

2042 NE Williamson Ct
Bend, OR 97701
Phone (541) 383-9071

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

Interoperability endpoints

  • Direct secure messaging: nvacchiocaulley84449@secure.stcharleshealthcare.org

Organizations & group practices 1

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": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1265806053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 71ST ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974784205",
            "telephone_number": "541-968-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2042 NE WILLIAMSON CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013760",
            "telephone_number": "541-706-6905",
            "fax_number": "541-706-6906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3311 Riverbend Dr",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974778800",
            "country_code": "US",
            "telephone_number": "541-968-6676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VACCHIO-CAULLEY",
        "first_name": "NOELLE",
        "middle_name": "DOMINIQUE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "174942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nvacchiocaulley84449@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2042 NE Williamson Ct",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977013760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.