Active NPI
Theodore Anthony Braich, M.D.
- Medical Oncology Physician
- Bend, OR
National Provider Identifier
1649286204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Oncology Physician
- License
- MD24320
- Practice address
- 2500 NE Neff Rd
Bend, OR 97701-6015 - Phone
- (541) 706-5800
- Fax
- (541) 706-6341
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD24320 | OR | |
| Medical Oncology Physician | 207RX0202X | MD24320 | OR | Primary |
| Hematology (Internal Medicine) Physician | 207RH0000X | MD24320 | OR |
Addresses
Primary practice location
2500 NE Neff Rd
Bend, OR 97701-6015
Mailing address
PO Box 5579
Bend, OR 97708-5579
Phone (541) 706-5800
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00411275 | Other | OR | MEDICARE RAILROAD |
| P00411275 | Other | OR | MEDICARE RAILROAD |
| 226900 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD24320 | OR | MD | Hematology (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- thbraich@directaddress.net
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481673600000",
"number": "1649286204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5579",
"city": "BEND",
"state": "OR",
"postal_code": "977085579",
"telephone_number": "541-706-5800",
"fax_number": "541-706-6341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 NE NEFF RD",
"city": "BEND",
"state": "OR",
"postal_code": "977016015",
"telephone_number": "541-706-5800",
"fax_number": "541-706-6341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAICH",
"first_name": "THEODORE",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2016-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "MD24320",
"primary": false
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "OR",
"license": "MD24320",
"primary": true
},
{
"code": "207RH0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology",
"state": "OR",
"license": "MD24320",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "00411275",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00411275",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "226900",
"state": "OR"
}
],
"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 Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.