Individual provider Active NPI

Pamela J Irby, MD

  • Family Medicine Physician
  • Redmond, OR
National Provider Identifier
1295773901
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD20521 Issued in OR
Practice address
211 NW Larch Ave
Redmond, OR 97756-1357
Phone
(541) 548-2164
Fax
(541) 548-0534
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X MD20521 OR
Family Medicine Physician 207Q00000X MD20521 OR Primary

Addresses

Primary practice location

211 NW Larch Ave
Redmond, OR 97756-1357

Mailing address

PO Box 1420
Redmond, OR 97756-0400
Phone (541) 548-2164

Other identifiers 2

IdentifierTypeStateIssuer
11131153OtherORCAQH ID
158487MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pirby17705@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100802000222 OR Practitioner - Family Practice 4385639137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Stanford University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • St. Charles Home Health Services Home health agency, Bend, OR, CCN 387026
  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047
  • St Charles Medical Center Prineville Hospital, Prineville, OR, CCN 381313
  • St Charles Madras Hospital, Madras, OR, CCN 381324

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Dec 1, 2010 Accepting new patients
St. Charles Health System, Inc. Family Medicine CurrentSince Dec 1, 2010 Accepting new patients
Cascade Medical Clinic, PC Family Medicine PastSince Jan 9, 2001 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

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

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

Organizations & group practices 3

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 6

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1295773901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1420",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977560400",
            "telephone_number": "541-548-2164",
            "fax_number": "541-548-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 NW LARCH AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561357",
            "telephone_number": "541-548-2164",
            "fax_number": "541-548-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRBY",
        "first_name": "PAMELA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OR",
            "license": "MD20521",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD20521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "11131153",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158487",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pirby17705@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "211 NW Larch Ave",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977561357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.