Individual provider Active NPI

Marin McCutcheon, MD

  • Internal Medicine Physician
  • Klamath Falls, OR
National Provider Identifier
1477934446
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD193847 Issued in OR
Practice address
2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone
(541) 274-6311
Fax
(541) 274-2004
NPI assigned
Jun 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD193847 OR Primary

Addresses

Primary practice location

2865 Daggett Ave
Klamath Falls, OR 97601-1106

Mailing address

PO Box 2120
Portland, OR 97208-2120
Phone (541) 274-6221

Other practice location 1

14445 Olive View Dr
2B-182
Sylmar, CA 91342-1437
Phone (818) 364-3252

Other practice location 2

3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 768-5111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmccutcheon214217@samhealth.direct-ci.com

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
I20210811000318 OR Practitioner - Internal Medicine 8224391198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians

Practice addresses (Care Compare)

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 274-6221

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Lakes Medical Center Inc CurrentSince Jun 4, 2024 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Jun 4, 2024 Accepting new patients

Locations

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

Interoperability endpoints

  • Direct secure messaging: mmccutcheon214217@samhealth.direct-ci.com

Organizations & group practices 2

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": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1477934446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2120",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972082120",
            "telephone_number": "541-274-6221",
            "fax_number": "541-274-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-6311",
            "fax_number": "541-274-2004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14445 Olive View Dr",
            "address_2": "2B-182",
            "address_purpose": "LOCATION",
            "city": "Sylmar",
            "state": "CA",
            "postal_code": "913421437",
            "country_code": "US",
            "telephone_number": "818-364-3252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303737",
            "country_code": "US",
            "telephone_number": "541-768-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCUTCHEON",
        "first_name": "MARIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD193847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmccutcheon214217@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3600 NW Samaritan Dr",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.