Individual provider Active NPI

Jean S Verheyden, MD

  • Otolaryngic Allergy Physician
  • Bend, OR
National Provider Identifier
1760464812
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X
License
MD25065 Issued in OR
Practice address
2450 NE Mary Rose PL
Suite 120
Bend, OR 97701-7132
Phone
(541) 382-3100
Fax
(541) 312-7050
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 25065 OR
Otolaryngic Allergy Physician 207YX0602X MD25065 OR Primary

Addresses

Primary practice location

2450 NE Mary Rose PL
Suite 120
Bend, OR 97701-7132

Mailing address

2450 NE Mary Rose PL
Suite 120
Bend, OR 97701-7132
Phone (541) 382-3100

Other identifiers 1

IdentifierTypeStateIssuer
286590MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, HI, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040621000551 OR Practitioner - Otolaryngology 5991780454 Reassigns benefits to 3 organizations
I20240626003540 HI Practitioner - Otolaryngology 5991780454 Reassigns benefits to 1 organization
I20260415002246 CA Practitioner - Otolaryngology 5991780454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
George Washington University School of Medicine, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5820 Owens Dr BLDG E 2ND Floor
Pleasanton, CA 94588-3900

Hospital & facility affiliations

  • Harney District Hospital Hospital, Burns, OR, CCN 381307
  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Merit-based Incentive Payment System (MIPS)

Final score
88.71 of 100Reported as group
Quality
71.18
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25065ORMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harney District Hospital CurrentSince Jan 1, 2024 Accepting new patients
Harney District Hospital CurrentSince Jan 1, 2024 Accepting new patients
Hawaii Permanente Medical Group Inc CurrentSince Jun 3, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 21, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients

Locations

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

557 W Washington St
Burns, OR 97720
Phone (541) 573-3682

559 W Washington St
Burns, OR 97720
Phone (541) 573-2074

271 N Egan Ave
Burns, OR 97720
Phone (541) 573-2301

9900 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-8240

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 6

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 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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1760464812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 NE MARY ROSE PL",
            "address_2": "SUITE 120",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017132",
            "telephone_number": "541-382-3100",
            "fax_number": "541-312-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 NE MARY ROSE PL",
            "address_2": "SUITE 120",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017132",
            "telephone_number": "541-382-3100",
            "fax_number": "541-312-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERHEYDEN",
        "first_name": "JEAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "25065",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "OR",
            "license": "MD25065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286590",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.