Organization Active NPI

Rob M Kassan M D LLC

  • Primary Care Clinic/Center
  • Bend, OR
National Provider Identifier
1740073741
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ROB M KASSAN M D LLC
Practice address
1105 SE Centennial St
Bend, OR 97702-1343
Phone
(541) 241-6471
NPI assigned
May 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Dr. Rob Kassan, MDNPI 1487681417
Title
Owner
Phone
(310) 650-7813

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1105 SE Centennial St
Bend, OR 97702-1343

Mailing address

445 Nutcracker Dr
Redmond, OR 97756-7329
Phone (310) 650-7813

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250702000658 OR Part B Supplier - Clinic/Group Practice 5890208839 Receives reassigned benefits from 1 practitioner
Practice locations: Bend, OR

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.

NPI Registry JSON

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1740073741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 NUTCRACKER DR",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977567329",
            "telephone_number": "310-650-7813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SE CENTENNIAL ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021343",
            "telephone_number": "541-241-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROB M KASSAN M D LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "KASSAN",
        "authorized_official_first_name": "ROB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-650-7813",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "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 Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.