NPIMap

Organization Active NPI

Central Oregon Radiology Assoc., P.C.

  • Diagnostic Radiology Physician
  • Bend, OR
National Provider Identifier
1659970168
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CENTRAL OREGON RADIOLOGY ASSOC., P.C.
Practice address
1475 SW Chandler Ave Ste 202
Bend, OR 97702-3240
Phone
(541) 312-5522
Fax
(541) 382-2719
NPI assigned
Oct 26, 2020
Organization subpart
Yes
Parent organization
CENTRAL OREGON RADIOLOGY ASSOC PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Authorized official

Name
Jamie Dyer
Title
Chief Patient Admin SRVS Officer
Phone
(541) 598-3232

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary
Radiology Clinic/Center 261QR0200X

Addresses

Primary practice location

1475 SW Chandler Ave Ste 202
Bend, OR 97702-3240

Mailing address

1460 NE Medical Center Dr
Bend, OR 97701-6061
Phone (541) 382-6633

Other names 1

  • CORA Vascular Interventional Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407000799 OR Part B Supplier - Clinic/Group Practice 9335132091 Receives reassigned benefits from 43 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bend, OR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Central Oregon Rad Assoc

Member organizations 12

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1659970168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016061",
            "telephone_number": "541-382-6633",
            "fax_number": "541-382-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 SW CHANDLER AVE STE 202",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023240",
            "telephone_number": "541-312-5522",
            "fax_number": "541-382-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OREGON RADIOLOGY ASSOC., P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL OREGON RADIOLOGY ASSOC PC",
        "enumeration_date": "2020-10-26",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "DYER",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CHIEF PATIENT ADMIN SRVS OFFICER",
        "authorized_official_telephone_number": "541-598-3232"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORA Vascular Interventional Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CORA Vascular Interventional Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.