Individual provider Active NPI

Sarah Conneely, N.P.

  • Nurse Practitioner
  • Bend, OR
National Provider Identifier
1770611121
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10021635 Issued in OR
Practice address
464 NE Norton Ave
Bend, OR 97701-4387
Phone
(541) 323-3358
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 564141 CA
Nurse Practitioner 363L00000X 10021635 OR Primary

Addresses

Primary practice location

464 NE Norton Ave
Bend, OR 97701-4387

Mailing address

464 NE Norton Ave
Bend, OR 97701-4387
Phone (541) 323-3358

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
I20250206003046 OR Practitioner - Nurse Practitioner 0042740920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, San Francisco School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Payson Flattery ND DC PCGroup PAC ID 3274551379, 3 clinicians

Practice addresses (Care Compare)

464 NE Norton Ave
Bend, OR 97701-4387
Phone (541) 323-3358

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10021635ORMDNurse Practitioner
564141CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Payson Flattery ND DC PC CurrentSince Feb 1, 2025 Accepting new patients

Locations

464 NE Norton Ave
Bend, OR 97701
Phone (541) 323-3358

Interoperability endpoints

  • Direct secure messaging: sarahconneely@cfim-or.direct.office.nextgen.com

Organizations & group practices 1

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 2

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1770611121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 NE NORTON AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014387",
            "telephone_number": "541-323-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 NE NORTON AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014387",
            "telephone_number": "541-323-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNEELY",
        "first_name": "SARAH",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "564141",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "10021635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.