Individual provider Active NPI

Elizabeth Banowetz, M.D.

  • Family Medicine Physician
  • Medford, OR
National Provider Identifier
1639406333
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD166932 Issued in OR
Practice address
910 S Central Ave
Medford, OR 97501-7854
Phone
(541) 535-6239
NPI assigned
Nov 17, 2009
Last updated
Apr 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD166932 OR Primary

Addresses

Primary practice location

910 S Central Ave
Medford, OR 97501-7854

Mailing address

931 Chevy Way
Medford, OR 97504-4127
Phone (541) 690-3555

Other practice location 1

4940 Hamrick Rd
Central Point, OR 97502-3072
Phone (541) 535-6239

Other practice location 2

638 Market St
Medford, OR 97504-6126
Phone (541) 535-6239

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
I20140613001856 OR Practitioner - Family Practice 6406097898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Davis School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4940 Hamrick Rd
Central Point, OR 97502-3072
Phone (541) 690-3600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica del Valle Family Health Care Center Inc. CurrentSince Jul 15, 2014 Accepting new patients

Locations

3617 S Pacific Hwy
Medford, OR 97501
Phone (541) 512-3182

4940 Hamrick Rd
Medford, OR 97502
Phone (541) 512-3900

638 Market St
Medford, OR 97504
Phone (541) 494-3840

910 S Central Ave
Medford, OR 97501
Phone (541) 618-1380

931 Chevy Way
Medford, OR 97504
Phone (541) 690-3555

Interoperability endpoints

  • Direct secure messaging: ebanowetz136831@direct.ochin.org

Organizations & group practices 1

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 3

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": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1639406333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-690-3555",
            "fax_number": "541-512-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S CENTRAL AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017854",
            "telephone_number": "541-535-6239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4940 Hamrick Rd",
            "address_purpose": "LOCATION",
            "city": "Central Point",
            "state": "OR",
            "postal_code": "975023072",
            "country_code": "US",
            "telephone_number": "541-535-6239",
            "fax_number": "541-512-1026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "638 Market St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975046126",
            "country_code": "US",
            "telephone_number": "541-535-6239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANOWETZ",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD166932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.