NPIMap

Individual provider Active NPI

Douglas Gordon Crane, M.D.

  • Internal Medicine Physician
  • Coquille, OR
National Provider Identifier
1689650673
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD22263 Issued in OR
Practice address
209 N Central Blvd
Coquille, OR 97423-1274
Phone
(541) 329-0144
Fax
(541) 329-0143
NPI assigned
Dec 21, 2005
Last updated
Jun 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD22263 OR Primary

Addresses

Primary practice location

209 N Central Blvd
Coquille, OR 97423-1274

Mailing address

PO Box 194
Coquille, OR 97423-0194
Phone (541) 329-0144

Other practice location 1

913 11th St SE Ste 1
Bandon, OR 97411-9168
Phone (541) 329-0144

Other identifiers 5

IdentifierTypeStateIssuer
288488MedicaidOR
R0000WFBTVOtherORGROUP PIN NUMBER
110199508OtherORRR MEDICARE PTAN NUMBER
CD8723OtherORRR MEDICARE GROUP NUMBER
0577260001OtherORDMERC NUMBER

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
I20100111000105 OR Practitioner - Internal Medicine 4284775461 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South West Internal Medicine LLCGroup PAC ID 1052691987, 4 clinicians
Southern Coos Health DistrictGroup PAC ID 1951219310, 25 clinicians

Practice addresses (Care Compare)

209 N Central Blvd
Coquille, OR 97423-1274
Phone (541) 329-0144

900 11TH St SE
Bandon, OR 97411-9114
Phone (541) 347-2426

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
18.46 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
61.55

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31497TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Coos Health District CurrentSince Oct 22, 2018 Accepting new patients
South West Internal Medicine LLC Internal Medicine CurrentSince Jan 14, 2017 Accepting new patients
Southern Coos Health District CurrentSince Oct 22, 2018 Accepting new patients

Locations

900 11th St SE
Bandon, OR 97411
Phone (541) 237-2426

913 11th St SE
Ste 1
Bandon, OR 97411
Phone (541) 329-0144

209 N Central Blvd
Coquille, OR 97423
Phone (541) 329-0144

940 E 5th St
Coquille, OR 97423
Phone (541) 396-3101

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1689650673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 194",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "974230194",
            "telephone_number": "541-329-0144",
            "fax_number": "541-329-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 N CENTRAL BLVD",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "974231274",
            "telephone_number": "541-329-0144",
            "fax_number": "541-329-0143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "913 11th St SE Ste 1",
            "address_purpose": "LOCATION",
            "city": "Bandon",
            "state": "OR",
            "postal_code": "974119168",
            "country_code": "US",
            "telephone_number": "541-329-0144",
            "fax_number": "541-329-0143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRANE",
        "first_name": "DOUGLAS",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD22263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288488",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PIN NUMBER",
            "identifier": "R0000WFBTV",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN NUMBER",
            "identifier": "110199508",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP NUMBER",
            "identifier": "CD8723",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC NUMBER",
            "identifier": "0577260001",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coquille, OR

Sources for this page

Verify at the official NPI Registry.