Individual provider Active NPI

Andreanna J Demarco, PA-C

  • Physician Assistant
  • Bend, OR
National Provider Identifier
1750539565
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA150374 Issued in OR
Practice address
1460 NE Medical Center Dr
Bend, OR 97701-6061
Phone
(541) 382-6633
Fax
(541) 382-2719
NPI assigned
Sep 4, 2008
Last updated
Mar 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA150374 OR Primary

Addresses

Primary practice location

1460 NE Medical Center Dr
Bend, OR 97701-6061

Mailing address

1460 NE Medical Center Dr
Bend, OR 97701-6061
Phone (541) 382-6633

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091209000093 OR Practitioner - Physician Assistant 6204975915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1460 NE Medical Ctr Dr
Bend, OR 97701-6061
Phone (541) 382-6633

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA150374ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Medical Imaging LLC CurrentSince Mar 6, 2021 Accepting new patients
Cascade Medical Imaging LLC Past Accepting new patients

Locations

1460 NE Medical Center Dr
Bend, OR 97701
Phone (541) 598-3218

1460 NE Medical Center Dr
Ste 170
Bend, OR 97701

1460 NE Medical Center Dr
Ste 180
Bend, OR 97701
Phone (541) 408-7691

1531 NW Canal Blvd
Ste 100
Redmond, OR 97756
Phone (541) 923-4202

1531 NW Canal Blvd
Ste 110
Redmond, OR 97756

Organizations & group practices 4

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 4

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": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1750539565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016061",
            "telephone_number": "541-382-6633",
            "fax_number": "541-382-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016061",
            "telephone_number": "541-382-6633",
            "fax_number": "541-382-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARCO",
        "first_name": "ANDREANNA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA150374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.