Individual provider Active NPI

Caleb Benjamin Hentges, DO

  • Pediatrics Physician
  • McMinnville, OR
National Provider Identifier
1326545161
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO215051 Issued in OR
Practice address
2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8805
Phone
(503) 726-1614
Fax
(503) 434-6290
NPI assigned
Apr 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OK7475 OK
Pediatrics Physician 208000000X DO215051 OR Primary

Addresses

Primary practice location

2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8805

Mailing address

2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8805
Phone (503) 472-6161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221011000114 TX Practitioner - Pediatric Medicine 7911255245 Reassigns benefits to 1 organization
I20230907003247 OR Practitioner - Pediatric Medicine 7911255245 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7475OKMDPharmacy Technician
OK7475OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Oct 2, 2022 Accepting new patients
Cherokee Nation CurrentSince Oct 2, 2022 Accepting new patients
Cherokee Nation Current Accepting new patients
Physicians Medical Center, P C Current Accepting new patients
Physicians Medical Center P C CurrentSince Oct 15, 2023 Accepting new patients
Cherokee Nation Current Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

19600 E Ross St
Tahlequah, OK 74464
Phone (539) 234-1000

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

2435 NE Cumulus Ave
Ste A
McMinnville, OR 97128
Phone (503) 472-6161

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1326545161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 NE CUMULUS AVE STE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288805",
            "telephone_number": "503-472-6161",
            "fax_number": "503-434-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 NE CUMULUS AVE STE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288805",
            "telephone_number": "503-726-1614",
            "fax_number": "503-434-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENTGES",
        "first_name": "CALEB",
        "middle_name": "BENJAMIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "OK7475",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "DO215051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

Verify at the official NPI Registry.