Joanna Marie Bautista Aquino-Laban, M.D.
Individual provider Active NPI Internal Medicine Physician · Springfield, OR
NPI 1336435536 · NPPES record last updated Aug 11, 2021
Key facts
- NPI
- 1336435536
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD166458 (OR)
- Practice address
- 3377 Riverbend Dr
Springfield, OR 97477-8803 - Phone
- (541) 222-6389
- Fax
- (541) 222-6385
- NPI assigned
- Jun 26, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 18
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Peacehealth
Practice addresses (Care Compare)
2801 NW Mercy Dr
Suite 350
Roseburg, OR 97471-2349
Phone (541) 222-2700
3311 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-7218
3333 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-7300
3355 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-6113
Hospital & facility affiliations
- Sacred Heart Medical Center - Riverbend
- Peace Harbor Medical Center
- Bay Area Hospital
- Peacehealth Cottage Grove Community Medical Center
- Samaritan Pacific Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140814002557 | OR | Practitioner - Internal Medicine | 0143443358 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD166458 | OR | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Hospitalist | Current |
Accepting new patients |
| Peacehealth | Past | Accepting new patients |
Locations
2801 NW Mercy Dr
Ste 350
Roseburg, OR 97471
Phone (541) 222-2700
Interoperability endpoints
- jaquinolaban61304@direct.peacehealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | MD166458 | OR | |
| Internal Medicine Physician | 207R00000X | MD166458 | OR | Yes |
Addresses
Primary practice location
3377 Riverbend Dr
Springfield, OR 97477-8803
Mailing address
3377 Riverbend Dr
Springfield, OR 97477-8803
Phone (541) 222-6389
Other providers in Springfield, OR
- Ramin Jaberabo Ansari
- Courtney Lee Apker
- Apple Seed Care
- Apria Healthcare LLC
- April Snow Care
- Aranda LMT LLC
- Leah Jean Archer
- John M Armitage
- Asha Stephen
- Tara Ashe
All providers in Springfield, OR · Internal Medicine Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.