Individual provider Active NPI

William Bradley Craft, MD

  • Surgery Physician
  • Medford, OR
National Provider Identifier
1689760506
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD22870 Issued in OR
Practice address
940 Royal Ave
Suite 420
Medford, OR 97504-6193
Phone
(541) 732-8388
Fax
(541) 618-9089
NPI assigned
Oct 5, 2006
Last updated
Oct 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD22870 OR Primary

Addresses

Primary practice location

940 Royal Ave
Suite 420
Medford, OR 97504-6193

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other identifiers 1

IdentifierTypeStateIssuer
287611MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address wcraft113540@oc.providencedirect.org
Direct Messaging Address wcraft113540@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519000394 OR Practitioner - General SurgeryPractitioner - Vascular Surgery 1456392489 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Utah School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 Crater Lake Ave
Medford, OR 97504-6241
Phone (541) 732-5545

1619 NW Hawthorne Ave
Suite 206
Grants Pass, OR 97526-6009
Phone (541) 732-7850

940 Royal Ave
Medford, OR 97504-6194

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD22870ORMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Jun 1, 2005 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 1, 2005 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 1, 2005 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 1, 2005 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

940 Royal Ave
Unit 100
Medford, OR 97504
Phone (541) 732-8388

940 Royal Ave
Unit 350
Medford, OR 97504
Phone (541) 732-7460

940 Royal Ave
Unit 420
Medford, OR 97504
Phone (541) 618-8388

Interoperability endpoints

  • Direct secure messaging: wcraft113540@oc.providencedirect.org

Organizations & group practices 7

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 1

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1689760506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 ROYAL AVE",
            "address_2": "SUITE 420",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046193",
            "telephone_number": "541-732-8388",
            "fax_number": "541-618-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAFT",
        "first_name": "WILLIAM",
        "middle_name": "BRADLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD22870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287611",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wcraft113540@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "940 Royal Ave Unit 100",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975046194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wcraft113540@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "940 Royal Ave",
            "address_2": "Suite 420",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975046193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.