Signature Hospice Bend, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SIGNATURE HOSPICE BEND, LLC

Practice address

454 NE Revere Ave
Bend, OR 97701-4019

Phone

(541) 382-5050

Fax

(541) 527-1717

NPI assigned

Apr 21, 2020

Organization subpart

No

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

Authorized official

Name

Mary Kofstad, NP

Title

Division President

Phone

(971) 224-2033

Specialties & licenses 1

Addresses

Other names 1

• Signature Healthcare at Home Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Northwest Hospice LLC

  • Community Based Hospice Care Agency
  • Tigard, OR
  • NPI 1205849965

  Member Of

  NPD member

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Tumalo Falls Healthcare LLC

  • Community Based Hospice Care Agency
  • Bend, OR
  • NPI 1578389771

  Sold to, 2025-05-01

  CMS change of ownership

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1851911648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7632 SW DURHAM RD STE 105",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 NE REVERE AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014019",
            "telephone_number": "541-382-5050",
            "fax_number": "541-527-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE HOSPICE BEND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-21",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "KOFSTAD",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIVISION PRESIDENT",
        "authorized_official_telephone_number": "971-224-2033",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Signature Healthcare at Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Signature Healthcare at Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paige Lyn Sidler
• Cory Alan Siebe, M.D.
• Susan P Siefken, OT
• Georgene Christine Siemsen, GNP
• Signature Home Health Bend, LLC
• Quincey Matsue Sigona
• Silkskyspa, LLC
• Gisela Rosa Silva
• Nicholas Silva, LMT, MMP,CA
• Ilana Silver, LCSW

• Community Based Hospice Care Agency in Bend, OR
• Providers in Bend, OR by specialty
• Community Based Hospice Care Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.