Individual provider Active NPI

Kellen Franklyn Mandehr, DO

  • Family Medicine Physician
  • Bend, OR
National Provider Identifier
1457097966
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
211237 Issued in OR
Practice address
929 SW Simpson Ave Ste 300
Bend, OR 97702-3599
Phone
(541) 389-7741
Fax
(541) 278-8375
NPI assigned
May 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 211237 OR Primary

Addresses

Primary practice location

929 SW Simpson Ave Ste 300
Bend, OR 97702-3599

Mailing address

PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119

Other practice location 1

3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Phone (541) 768-4906

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250828001187 OR Practitioner - Family Practice 5395124721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

929 SW Simpson Ave
Bend, OR 97702-3599
Phone (541) 389-7741

Hospital & facility affiliations

  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
211237ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Praxis Health, PC Family Medicine CurrentSince Oct 6, 2025 Accepting new patients
Praxis Health, PC CurrentSince Oct 6, 2025 Accepting new patients

Locations

929 SW Simpson Ave
Bend, OR 97702
Phone (541) 848-6642

929 SW Simpson Ave
Ste 300
Bend, OR 97702
Phone (541) 388-4333

Organizations & group practices 5

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": "1651968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1457097966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 SW SIMPSON AVE STE 300",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023599",
            "telephone_number": "541-389-7741",
            "fax_number": "541-278-8375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973305472",
            "country_code": "US",
            "telephone_number": "541-768-4906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDEHR",
        "first_name": "KELLEN",
        "middle_name": "FRANKLYN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-08",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "211237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.