NPIMap

Organization Active NPI

Northwest Medical Foundation of Tillamook

Doing business as Adventist Health Bayshore Medical Lincoln City

  • Rural Health Clinic/Center
  • Lincoln City, OR
National Provider Identifier
1811238322
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK
Doing business as
Adventist Health Bayshore Medical Lincoln City
Practice address
1105 SE Jetty Ave
Lincoln City, OR 97367-2632
Phone
(541) 614-0482
NPI assigned
Mar 7, 2013
Last updated
Mar 26, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHWEST MEDICAL FOUNDATION OF TILLAMOOKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Authorized official

Name
Ms. Gina F Seufert
Title
VP, Physician & Clinic Services
Phone
(503) 815-2414

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Critical Access Hospital 282NC0060X 141177 OR

Addresses

Primary practice location

1105 SE Jetty Ave
Lincoln City, OR 97367-2632

Mailing address

1000 3Rd St
Tillamook, OR 97141-3430

Other identifiers 1

IdentifierTypeStateIssuer
005533MedicaidOR

Other names 1

  • Adventist Health Bayshore Medical Lincoln City Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000676 OR Part B Supplier - Clinic/Group Practice 5092619569 Receives reassigned benefits from 218 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tillamook, OR; Welches, OR; Vernonia, OR; Sheridan, OR; Pacific City, OR; Manzanita, OR; Lincoln City, OR; Estacada, OR

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Tillamook Cty General

Locations

1105 SE Jetty Ave
Lincoln City, OR 97367
Phone (541) 265-4947

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1811238322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 3RD ST",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SE JETTY AVE",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973672632",
            "telephone_number": "541-614-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK",
        "enumeration_date": "2013-03-07",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "SEUFERT",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VP, PHYSICIAN & CLINIC SERVICES",
        "authorized_official_telephone_number": "503-815-2414",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "OR",
            "license": "141177",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005533",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Bayshore Medical Lincoln City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adventist Health Bayshore Medical Lincoln City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.