Individual provider Active NPI

Diklah Orevi, PA-C

  • Physician Assistant
  • Bend, OR
National Provider Identifier
1568720563
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA158116 Issued in OR
Practice address
2065 NE Tucson Way Apt 110
Bend, OR 97701-5182
Phone
(541) 383-3005
Fax
(541) 383-1883
NPI assigned
Apr 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 22099 CA
Physician Assistant 363A00000X PA158116 OR Primary

Addresses

Primary practice location

2065 NE Tucson Way Apt 110
Bend, OR 97701-5182

Mailing address

PO Box 4228
Portland, OR 97208-4228
Phone (541) 383-3005

Other practice location 1

61250 SE Coombs Pl
Bend, OR 97702-3704
Phone (541) 706-5930

Other practice location 2

930 SW Abbey St
Newport, OR 97365-4820
Phone (541) 574-1818

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120619000328 OR Practitioner - Physician Assistant 2466616685 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mosaic Community HealthGroup PAC ID 5395653497, 78 clinicians

Practice addresses (Care Compare)

2065 NE Tucson Way
Apt 110
Bend, OR 97701-5182
Phone (541) 383-3005

375 NW Beaver St
Suite 101
Prineville, OR 97754-1802
Phone (541) 316-6026

Hospital & facility affiliations

  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA158116ORMDPhysician Assistant
22099CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Sep 23, 2013 Accepting new patients
Mosaic Community Health CurrentSince Oct 14, 2024 Accepting new patients
St. Charles Health System, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Cep America LLC CurrentSince Sep 23, 2013 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

61250 SE Coombs Pl
Bend, OR 97702
Phone (541) 706-5930

2065 NE Tucson Way
Apt 110
Bend, OR 97701
Phone (541) 373-3005

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

375 NW Beaver St
Ste 101
Prineville, OR 97754
Phone (541) 316-6026

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

Interoperability endpoints

  • Direct secure messaging: dorevi724290@direct.ochin.org
  • Direct secure messaging: dorevi24424@coipa.gardenplot.direct-ci.com

Organizations & group practices 8

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": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1568720563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4228",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084228",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 NE TUCSON WAY APT 110",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977015182",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61250 SE Coombs Pl",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977023704",
            "country_code": "US",
            "telephone_number": "541-706-5930",
            "fax_number": "541-706-5931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "930 SW Abbey St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "OR",
            "postal_code": "973654820",
            "country_code": "US",
            "telephone_number": "541-574-1818",
            "fax_number": "541-574-1831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OREVI",
        "first_name": "DIKLAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "22099",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA158116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.