Individual provider Active NPI

Rob Kassan, MD

  • Family Medicine Physician
  • Bend, OR
National Provider Identifier
1487681417
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD209589 Issued in OR
Practice address
1105 SE Centennial St
Bend, OR 97702-1343
Phone
(541) 241-6471
NPI assigned
Jun 26, 2006
Last updated
May 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD209589 OR Primary
Family Medicine Physician 207Q00000X G67840 CA

Addresses

Primary practice location

1105 SE Centennial St
Bend, OR 97702-1343

Mailing address

445 Nutcracker Dr
Redmond, OR 97756-7329
Phone (310) 650-7813

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
I20220825001760 OR Practitioner - Family Practice 6608058516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Irvine, California College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1105 SE Centennial St
Bend, OR 97702-1343
Phone (541) 241-6471

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67840CAMDPharmacist
G67840CAMDFamily Medicine Physician
MD209589ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rob M Kassan M D LLC CurrentSince May 23, 2025 Accepting new patients
Santa Monica Bay Area Physicians Family Medicine Past Accepting new patients

Locations

1105 SE Centennial St
Bend, OR 97702
Phone (541) 209-6729

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1487681417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 NUTCRACKER DR",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977567329",
            "telephone_number": "310-650-7813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SE CENTENNIAL ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021343",
            "telephone_number": "541-241-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSAN",
        "first_name": "ROB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD209589",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G67840",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.