Michelle Petrofes, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD14685 Issued in OR

Practice address

620 Ranch Rd
Reedsport, OR 97467-1720

Phone

(541) 271-2163

Fax

(541) 271-4058

NPI assigned

Jul 6, 2006

Last updated

Dec 4, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lower Umpqua Hospital District

  • Critical Access Hospital
  • Reedsport, OR
  • NPI 1003874819
  Medicare reassignment NPD
• North Bend Medical Center Inc

  dba NBMC-Main

  • Multi-Specialty Clinic/Center
  • Coos Bay, OR
  • NPI 1407812365
  Medicare reassignment NPD
• Lower Umpqua Hospital District

  dba Lower Umpqua Hospital Pharmacy

  • Community/Retail Pharmacy
  • Reedsport, OR
  • NPI 1336334754
  NPD
• North Bend Medical Center Inc

  dba NBMC-Xray Ekg

  • Diagnostic Radiology Physician
  • Coos Bay, OR
  • NPI 1063428308
  NPD

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1902837099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 RANCH RD",
            "city": "REEDSPORT",
            "state": "OR",
            "postal_code": "974671720",
            "telephone_number": "541-271-2163",
            "fax_number": "541-271-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 RANCH RD",
            "city": "REEDSPORT",
            "state": "OR",
            "postal_code": "974671720",
            "telephone_number": "541-271-2163",
            "fax_number": "541-271-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROFES",
        "first_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD14685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276263",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Narang
• Mark Nuttall, D.M.D.
• Olor Enterprises LTD (Dynamic Hearing Solutions)
• Pacific Care Inpatient Services, LLC
• Pacific Sleep & Respiratory Diagnostics LLC
• Bobbie Jo Qualls, CHW
• Raymond G. Mans, OD PC (Florence Reedsport Eye Clinics)
• Rebecca Marie Rice, LCSW
• James B Richey, PHARM D.
• Karen Jean Robertson

• Family Medicine Physician in Reedsport, OR
• Providers in Reedsport, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.