NPIMap

Individual provider Active NPI

Luana Ionela Petre Nedita, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Roseburg, OR
National Provider Identifier
1629054085
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
MD24919 Issued in OR
Practice address
2460 NW Stewart Parkway
Suite 103
Roseburg, OR 97471-1516
Phone
(541) 672-9515
Fax
(541) 464-3177
NPI assigned
Dec 19, 2005
Last updated
Jan 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD24919 OR Primary
Pulmonary Disease Physician 207RP1001X MD24919 OR
Sleep Medicine (Internal Medicine) Physician 207RS0012X MD24919 OR

Addresses

Primary practice location

2460 NW Stewart Parkway
Suite 103
Roseburg, OR 97471-1516

Mailing address

PO Box 1700
Roseburg, OR 97470-0414
Phone (541) 672-9515

Other identifiers 1

IdentifierTypeStateIssuer
274893MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040514000049 OR Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 0749270569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Sleep Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centennial Medical Group IncGroup PAC ID 6103982962, 60 clinicians

Practice addresses (Care Compare)

2460 NW Stewart Pkwy
Roseburg, OR 97471-1516

2700 NW Stewart Pkwy
Roseburg, OR 97471-1281
Phone (541) 677-2452

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.4 of 100Reported as group
Quality
67.01
Promoting interoperability
99
Improvement activities
40
Cost
78.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD24919ORMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Medical Group Inc. PastSince Sep 27, 2020 Accepting new patients

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 4

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1629054085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1700",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700414",
            "telephone_number": "541-672-9515",
            "fax_number": "541-464-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 NW STEWART PARKWAY",
            "address_2": "SUITE 103",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711516",
            "telephone_number": "541-672-9515",
            "fax_number": "541-464-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRE NEDITA",
        "first_name": "LUANA",
        "middle_name": "IONELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "MD24919",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD24919",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "OR",
            "license": "MD24919",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274893",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.