Individual provider Active NPI

Erik Richard Fladmo, PA

  • Physician Assistant
  • Medford, OR
National Provider Identifier
1326693094
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
195095 Issued in OR
Practice address
1170 Royal Ave
Medford, OR 97504-6101
Phone
(541) 779-3522
Fax
(541) 779-3522
NPI assigned
Aug 8, 2019
Last updated
Nov 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 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 195095 OR Primary

Addresses

Primary practice location

1170 Royal Ave
Medford, OR 97504-6101

Mailing address

1170 Royal Ave
Medford, OR 97504-6101
Phone (541) 779-7331

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200220002951 OR Practitioner - Physician Assistant 6901233543 Reassigns benefits to 1 organization

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
Medford Ear Nose and Throat Clinic PCGroup PAC ID 1355338013, 8 clinicians

Practice addresses (Care Compare)

1170 Royal Ave
Medford, OR 97504-6101
Phone (541) 779-7331

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
195095ORMDPhysician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1326693094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 ROYAL AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046101",
            "telephone_number": "541-779-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 ROYAL AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046101",
            "telephone_number": "541-779-3522",
            "fax_number": "541-779-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLADMO",
        "first_name": "ERIK",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-08",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "195095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.