NPIMap

Organization Active NPI

Pacific Cascade Pain and Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • North Bend, OR
National Provider Identifier
1275167462
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
PACIFIC CASCADE PAIN AND ANESTHESIA LLC
Practice address
2040A Public Square CT
North Bend, OR 97459-1253
Phone
(541) 808-3553
Fax
(541) 808-3494
NPI assigned
Feb 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Authorized official

Name
Lina Dorfmeister, CRNANPI 1699875278
Title
Owner
Phone
(302) 757-9591

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
Certified Registered Nurse AnesthetistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

2040A Public Square CT
North Bend, OR 97459-1253

Mailing address

PO Box 1385
Idaho Falls, ID 83403-1385
Phone (208) 525-2090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200411000397 OR Part B Supplier - Clinic/Group Practice 7810326972 Receives reassigned benefits from 2 practitioners
Practice locations: North Bend, OR

National Provider Directory

National Provider Directory

Locations

2699 N 17th St
Coos Bay, OR 97420
Phone (541) 266-3600

2040A Public Square Ct
North Bend, OR 97459
Phone (302) 757-9591

Practitioners & affiliated clinicians

Practitioners 6

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": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1275167462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1385",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834031385",
            "telephone_number": "208-525-2090",
            "fax_number": "208-523-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040A PUBLIC SQUARE CT",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974591253",
            "telephone_number": "541-808-3553",
            "fax_number": "541-808-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CASCADE PAIN AND ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "DORFMEISTER",
        "authorized_official_first_name": "LINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-757-9591",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.