Individual provider Active NPI

Whitney Lundy

  • Social Worker
  • Bend, OR
National Provider Identifier
1417619370
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
L17621 Issued in OR
Practice address
2065 NE Tucson Way Apt 110
Bend, OR 97701-5182
Phone
(541) 383-3005
Fax
(541) 383-1883
NPI assigned
Oct 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X L17621 OR Primary

Addresses

Primary practice location

2065 NE Tucson Way Apt 110
Bend, OR 97701-5182

Mailing address

PO Box 4228
Portland, OR 97208-4228
Phone (541) 383-3005

Other practice location 1

375 NW Beaver St Ste 101
Prineville, OR 97754-1802
Phone (541) 383-3005

Other identifiers 1

IdentifierTypeStateIssuer
L17621OtherORSTATE 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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260204001253 OR Practitioner - Clinical Social Worker 0749768323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mosaic Community HealthGroup PAC ID 5395653497, 78 clinicians

Practice addresses (Care Compare)

375 NW Beaver St
Suite 101
Prineville, OR 97754-1802
Phone (541) 316-6026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L17621ORMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Community Health CurrentSince Feb 2, 2026 Accepting new patients

Locations

2065 NE Tucson Way
Apt 110
Bend, OR 97701
Phone (541) 373-3005

375 NW Beaver St
Ste 101
Prineville, OR 97754
Phone (541) 316-6026

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1417619370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4228",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084228",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 NE TUCSON WAY APT 110",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977015182",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 NW Beaver St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Prineville",
            "state": "OR",
            "postal_code": "977541802",
            "country_code": "US",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDY",
        "first_name": "WHITNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "L17621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "L17621",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.