Active NPI
Megan Marie Condon, PAC
- Surgical Physician Assistant
- Bend, OR
National Provider Identifier
1306180062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA161017
- Practice address
- 1501 NE Medical Center Dr
Bend, OR 97701-6051 - Phone
- (541) 382-4900
- NPI assigned
- Nov 19, 2012
- Last updated
- Jan 10, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA161017 | OR | Primary |
Addresses
Primary practice location
1501 NE Medical Center Dr
Bend, OR 97701-6051
Mailing address
PO Box 6048
Bend, OR 97708-6048
Phone (541) 382-4900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500651056 | Medicaid | OR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mcondon12802@directmsg.bmctotalcare.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641772800000",
"number": "1306180062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6048",
"city": "BEND",
"state": "OR",
"postal_code": "977086048",
"telephone_number": "541-382-4900",
"fax_number": "503-464-5050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 NE MEDICAL CENTER DR",
"city": "BEND",
"state": "OR",
"postal_code": "977016051",
"telephone_number": "541-382-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONDON",
"first_name": "MEGAN",
"middle_name": "MARIE",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-19",
"last_updated": "2022-01-10",
"certification_date": "2022-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "OR",
"license": "PA161017",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500651056",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mcondon12802@directmsg.bmctotalcare.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1501 NE Medical Center Dr",
"city": "Bend",
"state": "OR",
"country_code": "US",
"postal_code": "977016051",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.