Willie Underwood III, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD214003 Issued in OR

Practice address

1247 NE Medical Center Dr Ste C
Bend, OR 97701-3786

Phone

(541) 322-5753

Fax

(541) 278-8368

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, WV2 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 2

Specialty

Urology

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Princeton Community Hospital Assn. Inc.Group PAC ID 3678482221, 174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Princeton Community Hospital Assn Inc Hospital, Princeton, WV, CCN 510046

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wunderwood26596@direct.xtensys.com
• Direct secure messaging: wunderwood170471@direct-guthrie.org
• Direct secure messaging: willie.underwood@arn.eclinicaldirectplus.com

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.

• Princeton Community Hospital Assn Inc.

  • Urology Physician
  • Princeton, WV
  • NPI 1093917643
  Medicare reassignment Care Compare group
• Arnot Medical Services PLLC

  • Internal Medicine Physician
  • Elmira, NY
  • NPI 1427326768
  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Corning, NY
  • NPI 1134178635
  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644
  NPD
• University Physician Group

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797
  NPD (past)
• University Urology

  • Urology Physician
  • Detroit, MI
  • NPI 1710910351
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Princeton Community Hospital Assn., Inc.

  • General Acute Care Hospital
  • Princeton, WV
  • NPI 1558313213
  Care Compare affiliation

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1831136829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 NE MEDICAL CENTER DR STE C",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013786",
            "telephone_number": "541-322-5753",
            "fax_number": "541-278-8368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Elm and Carlton St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142630001",
            "country_code": "US",
            "telephone_number": "716-845-2300",
            "fax_number": "716-845-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "WILLIE",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "250131",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "MD214003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03038759",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ulrich Eyecare, LLC
• Gretchen Ulrich
• Sierrah Umhauer, LMT
• Leah D Umnitz, FNP
• Michael David Underwood, HASP
• University Professional Services
• Jane Harrell Unterberger, PMHNP-BC
• Christopher James Untiedt, QMHP
• Megan Unverzagt, QMHA-R
• Dawn Unze, LMT

• Urology Physician in Bend, OR
• Providers in Bend, OR by specialty
• Urology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.