Individual provider Active NPI

David Martin Tretheway, MD

  • Internal Medicine Physician
  • Redmond, OR
National Provider Identifier
1831152982
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14982 Issued in OR
Practice address
236 NW Kingwood Ave
Suite B
Redmond, OR 97756-1324
Phone
(541) 548-7134
Fax
(541) 548-7196
NPI assigned
Apr 10, 2006
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 14982 OR
Internal Medicine Physician 207R00000X 14982 OR Primary

Addresses

Primary practice location

236 NW Kingwood Ave
Suite B
Redmond, OR 97756-1324

Mailing address

1555 SW Reindeer Ave
Redmond, OR 97756-9449
Phone (541) 548-4088

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
I20040624000495 OR Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 1850288374

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14982ORMDHospice and Palliative Medicine (Internal Medicine) Physician

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14996/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Clearpath HospiceRedmond, OR, CCN 381512 Hospice Corporate Director (100%) Feb 22, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, 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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1831152982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 SW REINDEER AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977569449",
            "telephone_number": "541-548-4088",
            "fax_number": "541-548-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 NW KINGWOOD AVE",
            "address_2": "SUITE B",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561324",
            "telephone_number": "541-548-7134",
            "fax_number": "541-548-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRETHEWAY",
        "first_name": "DAVID",
        "middle_name": "MARTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "OR",
            "license": "14982",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "14982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.