Individual provider Active NPI

John F Dauterman, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Roseburg, OR
National Provider Identifier
1861463044
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
MD23060 Issued in OR
Practice address
2700 NW Stewart Pkwy
Roseburg, OR 97470-1281
Phone
(541) 677-4313
Fax
(541) 677-4533
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X MD23060 OR Primary

Addresses

Primary practice location

2700 NW Stewart Pkwy
Roseburg, OR 97470-1281

Mailing address

2700 NW Stewart Pkwy
Roseburg, OR 97470-1281
Phone (541) 677-4313

Other identifiers 1

IdentifierTypeStateIssuer
287547MedicaidOR

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
I20090313000430 OR Practitioner - Pathology 0143387332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Duke University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centennial Medical Group IncGroup PAC ID 6103982962, 60 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Roseburg, OR, CCN 380027
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Medical Group Inc. Clinical Pathology/Laboratory Medicine CurrentSince Jan 1, 2009 Accepting new patients
Centennial Medical Group Inc. PastSince Sep 27, 2020 Accepting new patients

Locations

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

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

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1861463044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 NW STEWART PKWY",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701281",
            "telephone_number": "541-677-4313",
            "fax_number": "541-677-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 NW STEWART PKWY",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701281",
            "telephone_number": "541-677-4313",
            "fax_number": "541-677-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUTERMAN",
        "first_name": "JOHN",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "OR",
            "license": "MD23060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287547",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.