NPIMap

Organization Active NPI

Bend OB-GYN LLC

  • Obstetrics & Gynecology Physician
  • Bend, OR
National Provider Identifier
1730138777
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
BEND OB-GYN LLC
Practice address
2450 NE Mary Rose PL
Suite 220
Bend, OR 97701-7132
Phone
(541) 385-8050
Fax
(541) 385-8589
NPI assigned
May 8, 2006
Last updated
Apr 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Dr. Peter Edward Palacio, MDNPI 1295730158
Title
Owner
Phone
(541) 385-8050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

2450 NE Mary Rose PL
Suite 220
Bend, OR 97701-7132

Mailing address

2450 NE Mary Rose PL
Suite 220
Bend, OR 97701-7132
Phone (541) 385-8050

Other identifiers 1

IdentifierTypeStateIssuer
286781MedicaidOR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1730138777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 NE MARY ROSE PL",
            "address_2": "SUITE 220",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017132",
            "telephone_number": "541-385-8050",
            "fax_number": "541-385-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 NE MARY ROSE PL",
            "address_2": "SUITE 220",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017132",
            "telephone_number": "541-385-8050",
            "fax_number": "541-385-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEND OB-GYN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "PALACIO",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-385-8050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286781",
            "state": "OR"
        }
    ],
    "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 Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.