Individual provider Active NPI

Berta P Baldovino Navarro, MD

  • Pulmonary Disease Physician
  • Medford, OR
National Provider Identifier
1477857498
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD164887 Issued in OR
Practice address
555 Black Oak Drive
Suite 300a
Medford, OR 97504
Phone
(541) 732-7960
Fax
(541) 732-7961
NPI assigned
Jan 5, 2011
Last updated
Sep 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD164887 OR Primary

Addresses

Primary practice location

555 Black Oak Drive
Suite 300a
Medford, OR 97504

Mailing address

2620 East Barnett Rd
Suite H
Medford, OR 97504-8383
Phone (541) 732-7960

Other identifiers 1

IdentifierTypeStateIssuer
500670569MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20211012001768 NM Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7719100346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

465 Saint Michaels Dr
Suite 117
Santa Fe, NM 87505-7621
Phone (505) 984-2600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital CurrentSince Oct 25, 2021 Accepting new patients
St Vincent Hospital Current Accepting new patients
St. Vincent Hospital CurrentSince Oct 25, 2021 Accepting new patients

Locations

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

465 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-5287

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

Interoperability endpoints

  • Direct secure messaging: bbaldovino266152@christushealth.direct-ci.net

Organizations & group practices 4

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 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": "1294185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1477857498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 EAST BARNETT RD",
            "address_2": "SUITE H",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048383",
            "telephone_number": "541-732-7960",
            "fax_number": "541-732-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BLACK OAK DRIVE",
            "address_2": "SUITE 300A",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-732-7960",
            "fax_number": "541-732-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDOVINO NAVARRO",
        "first_name": "BERTA",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-05",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD164887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500670569",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.