NPIMap

Individual provider Active NPI

Joanna Marie Bautista Aquino-Laban, M.D.

  • Internal Medicine Physician
  • Springfield, OR
National Provider Identifier
1336435536
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD166458 Issued in OR
Practice address
3377 Riverbend Dr
Springfield, OR 97477-8803
Phone
(541) 222-6389
Fax
(541) 222-6385
NPI assigned
Jun 26, 2011
Last updated
Aug 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD166458 OR
Internal Medicine Physician 207R00000X MD166458 OR Primary

Addresses

Primary practice location

3377 Riverbend Dr
Springfield, OR 97477-8803

Mailing address

3377 Riverbend Dr
Springfield, OR 97477-8803
Phone (541) 222-6389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140814002557 OR Practitioner - Internal Medicine 0143443358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8527016039, 200 clinicians

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Hospitalist CurrentSince Jul 28, 2014 Accepting new patients
Peacehealth Past Accepting new patients

Locations

2801 NW Mercy Dr
Ste 350
Roseburg, OR 97471
Phone (541) 222-2700

Interoperability endpoints

  • Direct secure messaging: jaquinolaban61304@direct.peacehealth.org

Organizations & group practices 2

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 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1309046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1336435536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3377 RIVERBEND DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778803",
            "telephone_number": "541-222-6389",
            "fax_number": "541-222-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3377 RIVERBEND DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778803",
            "telephone_number": "541-222-6389",
            "fax_number": "541-222-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AQUINO-LABAN",
        "first_name": "JOANNA MARIE",
        "middle_name": "BAUTISTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-26",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD166458",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD166458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.