Individual provider Active NPI

Anthony Gunsul, D.O.

  • Family Medicine Physician
  • Bend, OR
National Provider Identifier
1366780066
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PG163086 Issued in OR
Practice address
61250 SE Coombs Place
Bend, OR 97702
Phone
(541) 706-5935
NPI assigned
Jan 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PG163086 OR Primary

Addresses

Primary practice location

61250 SE Coombs Place
Bend, OR 97702

Mailing address

PO Box 5579
Bend, OR 97708-5579

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address agunsul17973@secure.stcharleshealthcare.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160926001260 OR Practitioner - Family Practice 7911294509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164

61250 SE Coombs PL
Family Care Clin
Bend, OR 97702-3704
Phone (541) 706-5935

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PG163086ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. Family Medicine CurrentSince Sep 26, 2016 Accepting new patients
St. Charles Health System, Inc. CurrentSince Sep 26, 2016 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

61250 SE Coombs Pl
Bend, OR 97702
Phone (541) 706-5930

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

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 and National Provider Directory roles.

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": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1366780066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5579",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977085579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61250 SE COOMBS PLACE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "541-706-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNSUL",
        "first_name": "ANTHONY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-30",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "PG163086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agunsul17973@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "61250 SE Coombs Place",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.