Signature Home Health Bend, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SIGNATURE HOME HEALTH BEND, LLC

Doing business as

Signature Healthcare at Home

Practice address

454 NE Revere Ave
Bend, OR 97701-4019

Phone

(541) 382-5050

Fax

(541) 527-1717

NPI assigned

Apr 23, 2020

Last updated

Nov 13, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Kofstad, NPNPI 1104086065

Title

Division President

Phone

(971) 224-2033

Specialties & licenses 2

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

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

  dba Signature Healthcare at Home

  • Home Health Agency
  • Bend, OR
  • NPI 1306669023

  Sold to, 2025-01-01

  CMS change of ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary E. Kofstad, MSN-FNP

  • Family Nurse Practitioner
  • Billings, MT
  • NPI 1104086065
  NPD (past) Authorized official

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1942820568",
    "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 HOME HEALTH BEND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-23",
        "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": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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"
        }
    ]
}

• Russ Shy
• Paige Lyn Sidler
• Cory Alan Siebe, M.D.
• Susan P Siefken, OT
• Georgene Christine Siemsen, GNP
• Signature Hospice Bend, LLC (Signature Healthcare at Home)
• Quincey Matsue Sigona
• Silkskyspa, LLC
• Gisela Rosa Silva
• Nicholas Silva, LMT, MMP,CA

• Home Health Agency in Bend, OR
• Providers in Bend, OR by specialty
• Home Health 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.