Active NPI
Michael L Mara, M.D.
- Orthopaedic Hand Surgery Physician
- Bend, OR
National Provider Identifier
1366428237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- MD19422
- Practice address
- 1303 NE Cushing Dr
Ste 100
Bend, OR 97701-3730 - Phone
- (541) 330-8226
- Fax
- (541) 318-0373
- NPI assigned
- Dec 21, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthopaedic Hand Surgery Physician | 207XS0106X | MD19422 | OR | Primary |
Addresses
Primary practice location
1303 NE Cushing Dr
Ste 100
Bend, OR 97701-3730
Mailing address
1303 NE Cushing Dr
Suite 100
Bend, OR 97701-3887
Phone (541) 388-2333
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 074435 | Medicaid | OR | |
| 200026307 | Other | OR | RAILROAD MEDICARE |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD19422 | OR | MD | Orthopaedic Hand Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physicians of Central Oregon, LLC | Hand Surgery | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Bend, OR
- NPI 1679884027
Hand Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196294400000",
"number": "1366428237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1303 NE CUSHING DR",
"address_2": "SUITE 100",
"city": "BEND",
"state": "OR",
"postal_code": "977013887",
"telephone_number": "541-388-2333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1303 NE CUSHING DR",
"address_2": "STE 100",
"city": "BEND",
"state": "OR",
"postal_code": "977013730",
"telephone_number": "541-330-8226",
"fax_number": "541-318-0373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARA",
"first_name": "MICHAEL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-21",
"last_updated": "2007-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "OR",
"license": "MD19422",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "074435",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "200026307",
"state": "OR"
}
],
"endpoints": [],
"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 Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.