NPIMap

Individual provider Active NPI

Kit C McCalla, D.O., MBA

  • Orthopaedic Surgery Physician
  • Corvallis, OR
National Provider Identifier
1487626313
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
DO169772 Issued in OR
Practice address
3620 NW Samaritan Dr Ste 202
Corvallis, OR 97330-3785
Phone
(541) 768-4810
NPI assigned
Feb 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 147-321 WI
Orthopaedic Surgery Physician 207X00000X 3671 AZ
Orthopaedic Surgery Physician 207X00000X DO169772 OR Primary

Addresses

Primary practice location

3620 NW Samaritan Dr Ste 202
Corvallis, OR 97330-3785

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

820 E Grant St
Appleton, WI 54911-3483
Phone (920) 831-5050

Other practice location 2

10815 W McDowell Rd
Ste 303
Avondale, AZ 85392-5007
Phone (602) 424-0935

Other identifiers 2

IdentifierTypeStateIssuer
596 009MedicaidAZ
Z 119 971OtherAZMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmccalla123391@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050216000501 AZ Practitioner - Orthopedic Surgery 9537111752 Reassigns benefits to 1 organization
I20150123002111 OR Practitioner - Orthopedic Surgery 9537111752 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Hospital CorvallisGroup PAC ID 1557270725, 372 clinicians

Practice addresses (Care Compare)

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

3620 NW Samaritan Dr
Corvallis, OR 97330-4714

Hospital & facility affiliations

  • Good Samaritan Regional Medical Center Hospital, Corvallis, OR, CCN 380014
  • Samaritan Lebanon Community Hospital Hospital, Lebanon, OR, CCN 381323
  • Samaritan Albany General Hospital Hospital, Albany, OR, CCN 380022

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Business Administration

State licenses

LicenseStateTypeSpecialty
147-321WIMDOrthopaedic Surgery Physician
5102OKMDSpeech-Language Pathologist
3671AZMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
Bay Area Hospital District CurrentSince Sep 1, 2023 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Nov 10, 2014 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients
Yuma Regional Medical Center Orthopaedic Surgery CurrentSince Sep 1, 2011 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Nov 10, 2014 Accepting new patients
Bay Area Hospital District CurrentSince Sep 1, 2023 Accepting new patients
Laser Spine Institute of Arizona, LLC Past Accepting new patients
Arizona Physician Consultants Professional Corporation Orthopaedic Surgery Past Accepting new patients
Institute for Bone and Joint Disorders PC Orthopaedic Surgery Past Accepting new patients

Locations

2851 S Avenue B
Bldg 25
Yuma, AZ 85364
Phone (928) 336-7020

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

Dept LA 25339
Pasadena, CA 91185

1775 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-8090

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

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

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

3620 NW Samaritan Dr
Ste 202
Corvallis, OR 97330
Phone (541) 768-4810

Organizations & group practices 10

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 53

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 53

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1487626313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 NW SAMARITAN DR STE 202",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303785",
            "telephone_number": "541-768-4810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 E Grant St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549113483",
            "country_code": "US",
            "telephone_number": "920-831-5050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10815 W McDowell Rd",
            "address_2": "Ste 303",
            "address_purpose": "LOCATION",
            "city": "Avondale",
            "state": "AZ",
            "postal_code": "853925007",
            "country_code": "US",
            "telephone_number": "602-424-0935",
            "fax_number": "602-938-4241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCALLA",
        "first_name": "KIT",
        "middle_name": "C",
        "credential": "D.O., MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-04",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "147-321",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "3671",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "DO169772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "596 009",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z 119 971",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmccalla123391@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3620 NW Samaritan Dr Ste 202",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.