Individual provider Active NPI

Ertan Raif Esmer, MD

  • Otolaryngology Physician
  • Tigard, OR
National Provider Identifier
1619069887
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD25648 Issued in OR
Practice address
9250 SW Hall Blvd
Tigard, OR 97223
Phone
(503) 293-0161
Fax
(503) 452-3200
NPI assigned
Sep 28, 2006
Last updated
Jun 22, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD25648 OR Primary

Addresses

Primary practice location

9250 SW Hall Blvd
Tigard, OR 97223

Mailing address

9250 SW Hall Blvd
Tigard, OR 97223
Phone (503) 293-0161

Other identifiers 1

IdentifierTypeStateIssuer
213442MedicaidOR

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
I20050808000852 OR Practitioner - Otolaryngology 8820071012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
West Virginia University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bend Memorial Clinic PCGroup PAC ID 7214936533, 225 clinicians

Practice addresses (Care Compare)

815 SW Bond St
Suite 100
Bend, OR 97702-3593
Phone (541) 706-2525

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Memorial Clinic PC CurrentSince Dec 14, 2020 Accepting new patients
Bend Memorial Clinic PC CurrentSince Dec 14, 2020 Accepting new patients

Locations

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

815 SW Bond St
Bend, OR 97702
Phone (541) 382-4900

815 SW Bond St
#100
Bend, OR 97702
Phone (541) 706-2525

Interoperability endpoints

  • Direct secure messaging: eesmer17633@directmsg.bmctotalcare.com

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.

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1619069887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 SW HALL BLVD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-293-0161",
            "fax_number": "503-452-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 SW HALL BLVD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-293-0161",
            "fax_number": "503-452-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESMER",
        "first_name": "ERTAN",
        "middle_name": "RAIF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD25648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213442",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.