NPIMap

Individual provider Active NPI

Kevin DJ Ewanchyna, M.D.

  • Family Medicine Physician
  • Corvallis, OR
National Provider Identifier
1669416673
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD20353 Issued in OR
Practice address
3680 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone
(541) 754-1282
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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 MD20353 OR Primary

Addresses

Primary practice location

3680 NW Samaritan Dr
Corvallis, OR 97330-3737

Mailing address

444 NW Elks Dr
Corvallis, OR 97330-3745
Phone (541) 754-1120

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
I20040707001274 OR Practitioner - Family Practice 8022095900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Corvallis Clinic P CGroup PAC ID 1456244540, 128 clinicians

Practice addresses (Care Compare)

1705 Waverly Dr SE
Albany, OR 97322-6952
Phone (541) 754-1150

Hospital & facility affiliations

  • Good Samaritan Regional Medical Center Hospital, Corvallis, OR, CCN 380014

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
84.81
Promoting interoperability
100
Improvement activities
40
Cost
75.71

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
85.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Corvallis Clinic P C CurrentSince Nov 30, 2023 Accepting new patients
Good Samaritan Hospital Corvallis Past Accepting new patients
Firstcare Medical Foundation Family Medicine PastSince Sep 1, 2004 Accepting new patients

Locations

1705 Waverly Dr SE
Albany, OR 97322
Phone (541) 248-2023

1086 7th Ave SW
Ste 101
Albany, OR 97321
Phone (541) 812-3349

444 NW Elks Dr
Corvallis, OR 97330
Phone (541) 754-1256

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

3680 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 754-1282

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

1111 SW 10th St
Ste B
Newport, OR 97365
Phone (541) 754-1268

Interoperability endpoints

  • Direct secure messaging: kevin.ewanchyna.1@14349.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14349/brand/4/csg/42/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1669416673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303745",
            "telephone_number": "541-754-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-754-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWANCHYNA",
        "first_name": "KEVIN",
        "middle_name": "DJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD20353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.