Active NPI
Mary Manfredi, MD
- Internal Medicine Physician
- Bend, OR
National Provider Identifier
1376567388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD26327
- Practice address
- 1501 NE Medical Center Dr
Bend, OR 97701-6051 - Phone
- (541) 382-4900
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD26327 | OR | Primary |
Addresses
Primary practice location
1501 NE Medical Center Dr
Bend, OR 97701-6051
Mailing address
PO Box 6048
Bend, OR 97708-6048
Phone (541) 382-4900
Other practice location 1
929 SW Simpson Ave
Bend, OR 97702-3118
Phone (541) 389-7741
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 247131 | Medicaid | OR |
Other names 1
- Mary Sicotte
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mmanfredi19362@directmsg.bmctotalcare.com | Direct |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060329000766 | OR | Practitioner - Internal Medicine | 0547278731 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Oregon Health Sciences University School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Bend Memorial Clinic PC
Practice addresses (Care Compare)
815 SW Bond St
Suite 100
Bend, OR 97702-3593
Phone (541) 706-2525
Hospital & facility affiliations
- Home Health of Northwest, LLC
- Mission Home Health of Bend
- Partners Home Health
- St Charles Medical Center - Bend
- St Charles Medical Center Prineville
- St Charles Madras
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bend Memorial Clinic PC | Current | Accepting new patients | |
| Bend Memorial Clinic PC | Internal Medicine | Current | Accepting new patients |
Locations
1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354
815 SW Bond St
#100
Bend, OR 97702
Phone (541) 706-2525
815 SW Bond St
Bend, OR 97702
Phone (541) 382-4900
Interoperability endpoints
- mmanfredi19362@directmsg.bmctotalcare.com
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.
-
- Clinical Medical Laboratory
- Bend, OR
- NPI 1972144913
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Bend, OR
- NPI 1477929776
-
- Sleep Disorder Diagnostic Clinic/Center
- Bend, OR
- NPI 1164675963
Hospital
-
- Home Health Agency
- Bend, OR
- NPI 1609548031
-
- Home Health Agency
- Bend, OR
- NPI 1063581247
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658275200000",
"number": "1376567388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6048",
"city": "BEND",
"state": "OR",
"postal_code": "977086048",
"telephone_number": "541-382-4900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 NE MEDICAL CENTER DR",
"city": "BEND",
"state": "OR",
"postal_code": "977016051",
"telephone_number": "541-382-4900"
}
],
"practiceLocations": [
{
"address_1": "929 SW Simpson Ave",
"address_purpose": "LOCATION",
"city": "Bend",
"state": "OR",
"postal_code": "977023118",
"country_code": "US",
"telephone_number": "541-389-7741",
"fax_number": "541-278-8375",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANFREDI",
"first_name": "MARY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2022-07-20",
"certification_date": "2022-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD26327",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "247131",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mmanfredi19362@directmsg.bmctotalcare.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1501 NE Medical Center Dr",
"city": "Bend",
"state": "OR",
"country_code": "US",
"postal_code": "977016051",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MARY",
"last_name": "SICOTTE",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}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 Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.