NPIMap

Individual provider Active NPI

Patrick Edwards, MD

  • Family Medicine Physician
  • Coquille, OR
National Provider Identifier
1851351191
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD184477 Issued in OR
Practice address
790 E 5TH St
Coquille, OR 97423
Phone
(541) 396-3111
Fax
(806) 828-5824
NPI assigned
Mar 23, 2006
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G5016 TX
Family Medicine Physician 207Q00000X MD184477 OR Primary

Addresses

Primary practice location

790 E 5TH St
Coquille, OR 97423

Mailing address

940 E 5TH St
Coquille, OR 97423
Phone (806) 828-6577

Other identifiers 1

IdentifierTypeStateIssuer
500738203MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180214001027 OR Practitioner - Family Practice 7416976964 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coquille Valley HealthGroup PAC ID 2567902182, 20 clinicians

Practice addresses (Care Compare)

2699 N 17TH St
Coos Bay, OR 97420-2134
Phone (541) 266-3600

940 E 5TH St
Coquille, OR 97423-1666
Phone (541) 396-3101

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5016TXMDBehavioral Analyst
MD184477ORMDFamily Medicine Physician
G5016TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coquille Valley Hospital District CurrentSince Feb 1, 2018 Accepting new patients
Coquille Valley Health Family Medicine CurrentSince Oct 1, 2024 Accepting new patients
Coquille Valley Hospital District CurrentSince Feb 1, 2018 Accepting new patients
Coquille Valley Health CurrentSince Oct 1, 2024 Accepting new patients
Covenant Medical Group Family Medicine Past Accepting new patients
Covenant Health System Past Accepting new patients
Texas Tech University Health Sciences Center University Associates Family Medicine Past Accepting new patients

Locations

2699 N 17th St
Coos Bay, OR 97420
Phone (541) 266-3600

790 E 5th St
Coquille, OR 97423
Phone (541) 396-3101

940 E 5th St
Coquille, OR 97423
Phone (541) 396-3101

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5c5c3b5c-6128-40bc-b71b-102ccb82d7e7/

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1851351191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 E 5TH ST",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "97423",
            "telephone_number": "806-828-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 E 5TH ST",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "97423",
            "telephone_number": "541-396-3111",
            "fax_number": "806-828-5824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G5016",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD184477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500738203",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coquille, OR

Sources for this page

Verify at the official NPI Registry.