Individual provider Active NPI

Jessica L. Leblanc, MD

  • Family Medicine Physician
  • Bend, OR
National Provider Identifier
1457548380
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD164295 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
Sep 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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 MD164295 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

2577 NE Courtney Dr Ste 100
Bend, OR 97701-7752
Phone (541) 383-3005

Other identifiers 1

IdentifierTypeStateIssuer
500660703MedicaidOR

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
I20130906000052 OR Practitioner - Family Practice 6507050176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 2007
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)

2065 NE Tucson Way
Bend, OR 97701-5182
Phone (541) 383-3005

2084 NE Professional CT
Bend, OR 97701-6077
Phone (541) 383-3005

2577 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 383-3005

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Community Health CurrentSince Oct 1, 2013 Accepting new patients

Locations

2577 NE Courtney Dr
Ste 100
Bend, OR 97701
Phone (541) 923-4462

600 SW Columbia St
Ste 6210
Bend, OR 97702

2084 NE Professional Ct
Bend, OR 97701
Phone (541) 322-5753

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

Interoperability endpoints

  • Direct secure messaging: jleblanc121668@direct.ochin.org

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.

Hospital & facility affiliations 4

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": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1457548380",
    "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": "2577 NE Courtney Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977017752",
            "country_code": "US",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "JESSICA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD164295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500660703",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.