Individual provider Active NPI

John P Berreen, MD

  • Ophthalmology Physician
  • Bend, OR
National Provider Identifier
1780872184
Registry record updated Nov 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD22414 Issued in OR
Practice address
2275 NE Doctors Dr
Ste 2
Bend, OR 97701-6324
Phone
(541) 693-5050
Fax
(541) 693-5051
NPI assigned
Oct 10, 2007
Last updated
Nov 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD22414 OR Primary

Addresses

Primary practice location

2275 NE Doctors Dr
Ste 2
Bend, OR 97701-6324

Mailing address

2275 NE Doctors Dr
Ste 2
Bend, OR 97701-6324
Phone (541) 693-5050

Other identifiers 1

IdentifierTypeStateIssuer
288210MedicaidOR

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
I20040614000303 OR Practitioner - Ophthalmology 6406750785 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.75 of 100Reported as group
Quality
100
Improvement activities
40
Cost
79.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD22414ORMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Ophthalmology Ophthalmology CurrentSince Jun 20, 2011 Accepting new patients
Orion Eye Center LLC Ophthalmology CurrentSince Mar 7, 2014 Accepting new patients
Retina Clinic of the Cascades, PC Ophthalmology Past Accepting new patients

Locations

2357 NE Conners Ave
Ste 101
Bend, OR 97701
Phone (541) 383-2749

1775 SW Umatilla Ave
Redmond, OR 97756
Phone (541) 548-7170

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1780872184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 NE DOCTORS DR",
            "address_2": "STE 2",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016324",
            "telephone_number": "541-693-5050",
            "fax_number": "541-693-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 NE DOCTORS DR",
            "address_2": "STE 2",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016324",
            "telephone_number": "541-693-5050",
            "fax_number": "541-693-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERREEN",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-10",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "MD22414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288210",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.