Individual provider Active NPI

Robert R. Hoffner, PA-C

  • Physician Assistant
  • Medford, OR
National Provider Identifier
1366699803
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA167347 Issued in OR
Practice address
1600 Delta Waters Rd
107
Medford, OR 97504-9114
Phone
(541) 858-2515
Fax
(541) 858-2514
NPI assigned
Aug 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 PA167347 OR Primary

Addresses

Primary practice location

1600 Delta Waters Rd
107
Medford, OR 97504-9114

Mailing address

815 N Central Ave
Suite C
Medford, OR 97501-5873
Phone (541) 734-9030

Other identifiers 1

IdentifierTypeStateIssuer
PA167347OtherORMEDICAL LICENSE

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
I20150319000022 OR Practitioner - Physician Assistant 5496817611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Immediate Care, LLCGroup PAC ID 7618876723, 36 clinicians

Practice addresses (Care Compare)

1600 Delta Waters Rd
Suite 107
Medford, OR 97504-9114
Phone (541) 858-2515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
51574CAMDMarriage & Family Therapist
002197CTMDOccupational Therapist

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.

NPI Registry JSON

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366699803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 N CENTRAL AVE",
            "address_2": "SUITE C",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015873",
            "telephone_number": "541-734-9030",
            "fax_number": "541-734-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DELTA WATERS RD",
            "address_2": "107",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049114",
            "telephone_number": "541-858-2515",
            "fax_number": "541-858-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFNER",
        "first_name": "ROBERT",
        "middle_name": "R.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-27",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA167347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA167347",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.