Individual provider Active NPI

Robert Elder, DO

  • Family Medicine Physician
  • Eugene, OR
National Provider Identifier
1740635531
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OL60963219 Issued in WA
Practice address
2484 River Rd
Eugene, OR 97404-2042
Phone
(541) 222-7650
Fax
(541) 222-7676
NPI assigned
Apr 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OL60963219 WA Primary

Addresses

Primary practice location

2484 River Rd
Eugene, OR 97404-2042

Mailing address

200 Mullins Dr
Lebanon, OR 97355-3983

Other practice location 1

216 W 10th Ave Ste 204
Kennewick, WA 99336-6304
Phone (509) 221-5520

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
I20221014002623 OR Practitioner - Family Practice 8527471259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peacehealth Medical GroupGroup PAC ID 9032023270, 256 clinicians

Practice addresses (Care Compare)

2484 River Rd
Eugene, OR 97404-2042
Phone (541) 222-7650

Hospital & facility affiliations

  • Signature Healthcare at Home Home health agency, Eugene, OR, CCN 387140
  • Sacred Heart Home Health Home health agency, Springfield, OR, CCN 387023
  • Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102
  • Peacehealth Cottage Grove Community Medical Center Hospital, Cottage Grove, OR, CCN 381301

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OL60963219WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Medical Group Single Specialty CurrentSince Oct 10, 2022 Accepting new patients
Western University of Health Sciences Past Accepting new patients

Locations

1200 Hilyard St
Eugene, OR 97401
Phone (458) 205-7070

4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300

2484 River Rd
Eugene, OR 97404
Phone (541) 222-7600

Interoperability endpoints

  • Direct secure messaging: relder566754@direct.peacehealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1740635531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MULLINS DR",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2484 RIVER RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974042042",
            "telephone_number": "541-222-7650",
            "fax_number": "541-222-7676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 W 10th Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993366304",
            "country_code": "US",
            "telephone_number": "509-221-5520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELDER",
        "first_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-28",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OL60963219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.