Individual provider Active NPI

Haley Rose Segelke

  • Medical Physician Assistant
  • Bend, OR
National Provider Identifier
1386334373
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA224740 Issued in OR
Practice address
1302 NE 3Rd St
Bend, OR 97701-4333
Phone
(541) 398-7524
NPI assigned
May 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X PA224740 OR Primary

Addresses

Primary practice location

1302 NE 3Rd St
Bend, OR 97701-4333

Mailing address

8401 S Chambers Rd
Greenwood Village, CO 80112-3276

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
I20250507000506 OR Practitioner - Physician Assistant 8123545878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icco LLCGroup PAC ID 1355406729, 133 clinicians

Practice addresses (Care Compare)

108 NW Sisemore St
Suite 120
Bend, OR 97703-2869
Phone (541) 640-7625

1302 NE 3Rd St
Bend, OR 97701-4333
Phone (541) 398-7524

3737 Shasta Way
Suite a
Klamath Falls, OR 97603-4982
Phone (541) 640-7625

598 E 13TH Ave
Eugene, OR 97401-4783
Phone (541) 636-3473

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA224740ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icco LLC CurrentSince May 19, 2025 Accepting new patients
Icco, LLC Current Accepting new patients
Icco, LLC Past Accepting new patients

Locations

600 Jefferson St
Ste 600
Lafayette, LA 70501
Phone (337) 202-0720

108 NW Sisemore St
Ste 120
Bend, OR 97703
Phone (541) 213-2133

1302 NE 3rd St
Bend, OR 97701
Phone (541) 385-6388

1445 Gateway Blvd
Cottage Grove, OR 97424
Phone (541) 767-3023

186 W Ellendale Ave
Dallas, OR 97338
Phone (971) 900-4984

1800 Coburg Rd
Eugene, OR 97401
Phone (541) 342-1632

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

4040 W 11th Ave
Ste B
Eugene, OR 97402
Phone (458) 215-2311

2710 Willamette St
Eugene, OR 97405
Phone (541) 735-3161

3675 Pacific Ave
#101
Forest Grove, OR 97116
Phone (971) 762-4611

1890 NW 6th St
Grants Pass, OR 97526
Phone (541) 507-0684

1623 N 1st St
Hermiston, OR 97838
Phone (458) 300-9014

355 W 3rd Ave
Junction City, OR 97448
Phone (541) 998-2468

3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337

3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605

1755 SW Baker St
McMinnville, OR 97128
Phone (971) 900-4522

1226 Virginia Ave
North Bend, OR 97459
Phone (541) 305-4224

1555 S Highway 97
#101
Redmond, OR 97756
Phone (541) 204-4304

3818 SW 21st St
Ste 100
Redmond, OR 97756
Phone (541) 548-2899

1740 NW Goetz St
Roseburg, OR 97471
Phone (541) 672-4789

2920 Commercial St SE
Salem, OR 97302
Phone (541) 641-6053

445 Harlow Rd
Ste 100
Springfield, OR 97477
Phone (541) 228-3865

5781 Main St
Springfield, OR 97478
Phone (541) 284-1694

Organizations & group practices 3

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 2

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": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1386334373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 S CHAMBERS RD",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801123276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 NE 3RD ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014333",
            "telephone_number": "541-398-7524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGELKE",
        "first_name": "HALEY",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA224740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.