Northwest Center for Plastic Surgery, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

071570 Issued in OR

Legal business name

NORTHWEST CENTER FOR PLASTIC SURGERY, LLC

Practice address

743 Country Club Rd
Eugene, OR 97401-6019

Phone

(541) 683-0878

Fax

(541) 683-5206

NPI assigned

Mar 28, 2006

Last updated

Jun 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Thomas M Dreyer, M.D.NPI 1851353668

Title

Medical Director

Phone

(541) 683-0878

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417918772. Details of each certification follow.

• CCN 38C0001071 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 38C0001071

Legal name

Northwest Center for Plastic Surgery, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jul 18, 2005

Last certification

Jun 1, 2017

Ownership / control type

Proprietary

Facility address

743 Country Club Road
Eugene, OR 97401

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Dreyer, M.D.

  • Plastic Surgery Physician
  • Eugene, OR
  • NPI 1851353668
  Authorized official Same address or phone
• Cynthia A Dreyer, M.D.

  • Dermatology Physician
  • Eugene, OR
  • NPI 1407038342
  NPD (past)

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1417918772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 COUNTRY CLUB RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016019",
            "telephone_number": "541-683-0878",
            "fax_number": "541-683-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 COUNTRY CLUB RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016019",
            "telephone_number": "541-683-0878",
            "fax_number": "541-683-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST CENTER FOR PLASTIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "DREYER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "541-683-0878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "071570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "071570",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Eugene, OR
• Providers in Eugene, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.