Individual provider Active NPI

Alejandro Diaz Chavez, M.D

  • Pulmonary Disease Physician
  • Roseburg, OR
National Provider Identifier
1851731004
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD189966 Issued in OR
Practice address
2460 NW Stewart Pkwy Ste 103
Roseburg, OR 97471
Phone
(541) 672-9515
Fax
(541) 464-3177
NPI assigned
Jul 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD189966 OR
Pulmonary Disease Physician 207RP1001X MD189966 OR Primary

Addresses

Primary practice location

2460 NW Stewart Pkwy Ste 103
Roseburg, OR 97471

Mailing address

201 NW Medical Loop Ste 190
Roseburg, OR 97471-8835
Phone (541) 677-4319

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
I20190705001261 OR Practitioner - Pulmonary Disease 9032455910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centennial Medical Group IncGroup PAC ID 6103982962, 60 clinicians

Practice addresses (Care Compare)

2460 NW Stewart Pkwy
Roseburg, OR 97471-1516

2700 NW Stewart Pkwy
Roseburg, OR 97471-1281
Phone (541) 677-2452

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Roseburg, OR, CCN 380027
  • Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090

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
83.4 of 100Reported as group
Quality
67.01
Promoting interoperability
99
Improvement activities
40
Cost
78.48

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
MD189966ORMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Medical Group Inc. Pulmonary Disease CurrentSince Jul 1, 2019 Accepting new patients
Centennial Medical Group Inc. CurrentSince Sep 27, 2020 Accepting new patients

Locations

2460 NW Stewart Pkwy
Ste 103
Roseburg, OR 97471
Phone (541) 464-3181

2801 NW Mercy Dr
Ste 340
Roseburg, OR 97471
Phone (541) 677-2494

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

201 NW Medical Loop
Ste 190
Roseburg, OR 97471
Phone (541) 644-4319

Interoperability endpoints

  • Direct secure messaging: adiazchavez644444@fhsce.catholichealth.net

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1851731004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NW MEDICAL LOOP STE 190",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718835",
            "telephone_number": "541-677-4319",
            "fax_number": "541-677-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 NW STEWART PKWY STE 103",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "97471",
            "telephone_number": "541-672-9515",
            "fax_number": "541-464-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ CHAVEZ",
        "first_name": "ALEJANDRO",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "MD189966",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD189966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.