Individual provider Active NPI

John D Seidner, MD

  • Emergency Medicine Physician
  • Klamath Falls, OR
National Provider Identifier
1881637148
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD191862 Issued in OR
Practice address
2865 Daggett Ave
Klamath Falls, OR 97601
Phone
(541) 274-6175
Fax
(541) 274-6739
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 11338 NH
Emergency Medicine Physician 207P00000X MD191862 OR Primary

Addresses

Primary practice location

2865 Daggett Ave
Klamath Falls, OR 97601

Mailing address

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 274-6175

Other practice location 1

1 Elliot Way
Emergency Department
Manchester, NH 03103-3502
Phone (603) 663-2830

Other practice location 2

1 Elliot Way
Emergency Department
Manchester, NH 03103-3502
Phone (603) 663-2830

Other identifiers 3

IdentifierTypeStateIssuer
30203571MedicaidNH
H09471OtherNHHPHC
01Y003173NH03OtherNHATHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20211025002171 NM Practitioner - Emergency Medicine 5799790895 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11338MAMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Emergency Medicine CurrentSince Oct 25, 2021 Accepting new patients
Presbyterian Healthcare Services Current Accepting new patients
Hospitalist Medicine Physicians of New Mexico - Clovis, LLC Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Los Alamos Emergency Medical Associates Inc Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Presbyterian Healthcare Services Emergency Medicine CurrentSince Oct 25, 2021 Accepting new patients
Merrimack Emergency Physicians Past Accepting new patients

Locations

4515 Coors Blvd NW
Albuquerque, NM 87120
Phone (505) 596-2200

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340

4900 N Lovington Hwy
Hobbs, NM 88240
Phone (575) 492-5000

3917 West Rd
Los Alamos, NM 87544
Phone (505) 661-9584

4801 Beckner Rd
#F
Santa Fe, NM 87507
Phone (505) 772-1234

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

Interoperability endpoints

  • Direct secure messaging: jseidner268097@christushealth.direct-ci.net
  • Direct secure messaging: jseidner207071@direct.phs.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1881637148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-6175",
            "fax_number": "541-274-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "97601",
            "telephone_number": "541-274-6175",
            "fax_number": "541-274-6739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Elliot Way",
            "address_2": "EMERGENCY DEPARTMENT",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031033502",
            "country_code": "US",
            "telephone_number": "603-663-2830",
            "fax_number": "603-663-1849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Elliot Way",
            "address_2": "EMERGENCY DEPARTMENT",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031033502",
            "country_code": "US",
            "telephone_number": "603-663-2830",
            "fax_number": "603-663-1849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEIDNER",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "11338",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD191862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30203571",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "H09471",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHEM BCBS",
            "identifier": "01Y003173NH03",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.