NPIMap

Organization Active NPI

Oregon Vascular Specialists LLC

  • Vascular Surgery Physician
  • Bend, OR
National Provider Identifier
1669917167
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
OREGON VASCULAR SPECIALISTS LLC
Practice address
1550 NE 27TH St Ste 100
Bend, OR 97701
Phone
(541) 313-8111
Fax
(541) 313-8112
NPI assigned
Dec 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Authorized official

Name
Wayne K. NelsonNPI 1992909766
Title
Owner
Phone
(541) 313-8111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1550 NE 27TH St Ste 100
Bend, OR 97701

Mailing address

1550 NE 27TH St Ste 100
Bend, OR 97701-7728
Phone (541) 313-8111

Other practice location 1

2600 NEFF Rd
Bend, OR 97701
Phone (888) 247-1869 ext. 7014

Other practice location 2

1550 NE 27th St Ste 100
Bend, OR 97701
Phone (541) 313-8111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170622001858 OR Part B Supplier - Clinic/Group Practice 8022386663 Receives reassigned benefits from 12 practitioners
Practice locations: Bend, OR; Klamath Falls, OR; Portland, OR; Redmond, OR; Salem, OR; Wilsonville, OR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2166313Oregon Vascular Specialists LLC1550 NE 27TH Street, Suite 100, Bend, OR 97701Certificate of waiverMay 14, 2027

National Provider Directory

National Provider Directory

Locations

1550 NE 27th St
Ste 100
Bend, OR 97701
Phone (541) 313-8111

4052 S 6th St
Klamath Falls, OR 97603
Phone (541) 313-8111

3818 SW 21st St
Ste 201
Redmond, OR 97756
Phone (541) 313-8111

25030 SW Parkway Ave
Ste 200
Wilsonville, OR 97070
Phone (503) 612-0498

25030 SW Parkway Ave
Ste 100
Wilsonville, OR 97070
Phone (503) 582-1073

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDIHDD

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1482192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1669917167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 NE 27TH ST STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017728",
            "telephone_number": "541-313-8111",
            "fax_number": "541-313-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 NE 27TH ST STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-313-8111",
            "fax_number": "541-313-8112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 NEFF Rd",
            "address_purpose": "LOCATION",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "country_code": "US",
            "telephone_number": "888-247-1869 x7014",
            "fax_number": "888-247-1864",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 NE 27th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "97701",
            "country_code": "US",
            "telephone_number": "541-313-8111",
            "fax_number": "541-313-8112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OREGON VASCULAR SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-20",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-313-8111"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.