NPIMap

Individual provider Active NPI

Loren Micahel Tetzlaff, PA-C

  • Physician Assistant
  • Albany, OR
National Provider Identifier
1295386506
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA195275 Issued in OR
Practice address
400 Hickory St NW Ste 200
Albany, OR 97321-1700
Phone
(541) 812-5800
NPI assigned
Sep 27, 2019
Last updated
Nov 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 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 PA195275 OR Primary

Addresses

Primary practice location

400 Hickory St NW Ste 200
Albany, OR 97321-1700

Mailing address

PO Box 1188
Corvallis, OR 97339-1188

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ltetzlaff175401@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191127002167 OR Practitioner - Physician Assistant 0345673695 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany General HospitalGroup PAC ID 9931097987, 191 clinicians
Mid-Valley Healthcare IncGroup PAC ID 2769391523, 143 clinicians

Practice addresses (Care Compare)

1046 6TH Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

400 Hickory St NW
Albany, OR 97321-1700

400 N Santiam Hwy
Lebanon, OR 97355
Phone (541) 451-6388

534 Pleasant View Way NW
Albany, OR 97321-1700

705 Elm St SW
Suite 200
Albany, OR 97321-1957
Phone (541) 812-4850

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
92.31
Promoting interoperability
100
Improvement activities
40
Cost
80.9

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Pacific Health Services, Inc CurrentSince Jan 1, 2026 Accepting new patients
Samaritan Pacific Health Services, Inc. CurrentSince Jan 24, 2026 Accepting new patients
Albany General Hospital CurrentSince Sep 30, 2019 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Jan 24, 2026 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Jan 1, 2026 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Dec 29, 2025 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Jun 1, 2025 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Jun 1, 2025 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Sep 30, 2019 Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince Jan 1, 2026 Accepting new patients
Albany General Hospital CurrentSince Sep 30, 2019 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Jan 1, 2026 Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Sep 30, 2019 Accepting new patients

Locations

400 Hickory St NW
Ste 200
Albany, OR 97321
Phone (541) 812-5800

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

777 NW 9th St
Ste 102
Corvallis, OR 97330
Phone (541) 768-6769

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

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 66

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

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1295386506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1188",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HICKORY ST NW STE 200",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211700",
            "telephone_number": "541-812-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETZLAFF",
        "first_name": "LOREN",
        "middle_name": "MICAHEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-27",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA195275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ltetzlaff175401@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "400 Hickory St NW Ste 200",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.