Individual provider Active NPI

Patrick Martin Plummer, M.D.

  • Sleep Medicine (Otolaryngology) Physician
  • Ontario, OR
National Provider Identifier
1508848474
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Otolaryngology) PhysicianTaxonomy code 207YS0012X
License
MD16163 Issued in OR
Practice address
2586 Lauren Dr
Ontario, OR 97914-5301
Phone
(208) 249-4050
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Otolaryngology) Physician 207YS0012X M-9673 ID
Sleep Medicine (Otolaryngology) Physician 207YS0012X MD16163 OR Primary

Addresses

Primary practice location

2586 Lauren Dr
Ontario, OR 97914-5301

Mailing address

2586 Lauren Dr
Ontario, OR 97914-5301
Phone (208) 249-4050

Other identifiers 2

IdentifierTypeStateIssuer
003424000MedicaidID
096198MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050222000197 OR Practitioner - Sleep MedicinePractitioner - Otolaryngology 5799738522 Practice locations: Ontario, OR
I20070604000688 ID Practitioner - OtolaryngologyPractitioner - Other (Physician) 5799738522 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-9673IDMDSleep Medicine (Otolaryngology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Walter Knox Memorial Hospital Current Accepting new patients
Ontario Ear, Nose and Throat PastSince Jul 1, 2007 Accepting new patients

Locations

1202 E Locust St
Emmett, ID 83617
Phone (208) 365-2338

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/eb237299-e2be-4fd4-aca6-5fa7adcd28c1/
  • Direct secure messaging: pplummer637633@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1508848474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2586 LAUREN DR",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979145301",
            "telephone_number": "208-249-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2586 LAUREN DR",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979145301",
            "telephone_number": "208-249-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUMMER",
        "first_name": "PATRICK",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "ID",
            "license": "M-9673",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "OR",
            "license": "MD16163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003424000",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096198",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

Verify at the official NPI Registry.