Individual provider Active NPI

Ernesto Jimenez, D.O.

  • Family Medicine Physician
  • Medford, OR
National Provider Identifier
1487092045
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO179266 Issued in OR
Practice address
3617 S Pacific Hwy
Medford, OR 97501-8957
Phone
(541) 535-6239
NPI assigned
Jun 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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 DO179266 OR Primary

Addresses

Primary practice location

3617 S Pacific Hwy
Medford, OR 97501-8957

Mailing address

931 Chevy Way
Medford, OR 97504-4127

Other practice location 1

638 Market St
Medford, OR 97504-6126
Phone (541) 535-6239

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
I20161021001616 OR Practitioner - Family Practice 0446553911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Clinica del Valle Family Health Care Center IncGroup PAC ID 0244143089, 59 clinicians

Practice addresses (Care Compare)

3617 S Pacific Hwy
Medford, OR 97501-8957
Phone (541) 535-6239

Hospital & facility affiliations

  • Assured Home Health Home health agency, Grants Pass, OR, CCN 387076
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Providence Medford Medical Center Hospital, Medford, OR, CCN 380075
  • Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica del Valle Family Health Care Center Inc. CurrentSince Sep 30, 2024 Accepting new patients

Locations

931 Chevy Way
Medford, OR 97504
Phone (541) 690-3555

3617 S Pacific Hwy
Medford, OR 97501
Phone (541) 512-3182

638 Market St
Medford, OR 97504
Phone (541) 494-3840

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": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1487092045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 S PACIFIC HWY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975018957",
            "telephone_number": "541-535-6239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "638 Market St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975046126",
            "country_code": "US",
            "telephone_number": "541-535-6239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ERNESTO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-05",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO179266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.