Individual provider Active NPI

Theodore Anthony Braich, M.D.

  • Medical Oncology Physician
  • Bend, OR
National Provider Identifier
1649286204
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
MD24320 Issued in OR
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

Updated by the provider on Dec 14, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00411275OtherORMEDICARE RAILROAD
P00411275OtherORMEDICARE RAILROAD
226900MedicaidOR

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

LicenseStateTypeSpecialty
MD24320ORMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.