Active NPI
Diklah Orevi, PA-C
- Physician Assistant
- Bend, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA158116
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 Health
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA158116 | OR | MD | Physician Assistant |
| 22099 | CA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America LLC | Current | Accepting new patients | |
| Mosaic Community Health | Current | Accepting new patients | |
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| Cep America LLC | Current | 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
- dorevi724290@direct.ochin.org
- 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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Bend, OR
- NPI 1376714543
OR
-
- Emergency Medicine Physician
- Coos Bay, OR
- NPI 1063893402
-
- Emergency Medicine Physician
- Fort Lauderdale, FL
- NPI 1700747946
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Sleep Disorder Diagnostic Clinic/Center
- Bend, OR
- NPI 1164675963
Hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.