Individual provider Active NPI

Jesse Allen Dorfmeister, FNP

  • Family Nurse Practitioner
  • Coos Bay, OR
National Provider Identifier
1407362197
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201709649NP-PP Issued in OR
Practice address
1900 Woodland Dr
Coos Bay, OR 97420-2045
Phone
(541) 267-5151
NPI assigned
Dec 18, 2017
Last updated
Dec 18, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201709649NP-PP OR Primary

Addresses

Primary practice location

1900 Woodland Dr
Coos Bay, OR 97420-2045

Mailing address

95022 Country LN
Coos Bay, OR 97420-7376
Phone (302) 757-9874

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
I20171228000177 OR Practitioner - Nurse Practitioner 9133487911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Bend Medical Center IncGroup PAC ID 5597677716, 92 clinicians

Practice addresses (Care Compare)

1900 Woodland Dr
Coos Bay, OR 97420-2045
Phone (541) 267-5151

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201709649NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Bend Medical Center Inc CurrentSince Feb 1, 2018 Accepting new patients
Pacific Cascade Pain and Anesthesia LLC Past Accepting new patients
North Bend Medical Center Past Accepting new patients

Locations

1900 Woodland Dr
Coos Bay, OR 97420
Phone (541) 267-5151

Interoperability endpoints

  • Direct secure messaging: jdorfmeister124425@secure.stcharleshealthcare.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1407362197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95022 COUNTRY LN",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974207376",
            "telephone_number": "302-757-9874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202045",
            "telephone_number": "541-267-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORFMEISTER",
        "first_name": "JESSE",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-18",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201709649NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

Verify at the official NPI Registry.