Bend Memorial Clinic PC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BEND MEMORIAL CLINIC PC

Doing business as

Bend Memorial Clinic PC dba Summit Health

Practice address

1501 NE Medical Center Dr
Bend, OR 97701-6051

Phone

(541) 382-2811

NPI assigned

Oct 1, 2019

Last updated

Apr 14, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

BEND MEMORIAL CLINIC PC DBA SUMMIT HEALTHAs reported in NPPES

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

Authorized official

Name

Jessie Dover

Title

Credentialing Coordinator

Phone

(541) 706-2495

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bend Memorial Clinic PC dba Summit Health Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Bend Memorial Clinic PC

  dba Summit Health

  • Family Medicine Physician
  • Bend, OR
  • NPI 1699827477

  O20061215000022

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Bend Memorial Clinic PC

Locations

Practitioners 396

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.

• Alyssa D Abbey, PA-C

  • Medical Physician Assistant
  • Bend, OR
  • NPI 1992830152
  NPD
• Travis Austin Abele, MD

  • Diagnostic Radiology Physician
  • Bend, OR
  • NPI 1871792168
  NPD
• John Robert Allen, M.D.

  • Internal Medicine Physician
  • Bend, OR
  • NPI 1043304462
  NPD
• Kurt W Andreason, M.D.

  • Ophthalmology Physician
  • Bend, OR
  • NPI 1013990027
  NPD
• Robert Joaquin Andrews, M.D.

  • Gastroenterology Physician
  • Bend, OR
  • NPI 1568805836
  NPD
• Kathleen C Antolak, M.D.

  • Family Medicine Physician
  • Bend, OR
  • NPI 1316975741
  NPD
• Stephen B. Archer, M.D.

  • Surgery Physician
  • Bend, OR
  • NPI 1699750307
  NPD
• Alyssa Argabright, PA-C

  • Surgical Physician Assistant
  • Bend, OR
  • NPI 1326418104
  NPD
• Matt S Ashley, M.D.

  • Urology Physician
  • Bend, OR
  • NPI 1013294941
  NPD
• Sanaz W. Askari, D.O.

  • Internal Medicine Physician
  • Bend, OR
  • NPI 1437248358
  NPD
• Sarah Atkin, PA-C

  • Physician Assistant
  • Bend, OR
  • NPI 1427673318
  NPD
• Joseph F Bachtold, DO

  • Family Medicine Physician
  • Bend, OR
  • NPI 1437134582
  NPD

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681430400000",
    "number": "1972144913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016099",
            "telephone_number": "541-382-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016051",
            "telephone_number": "541-382-2811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "865 SW Veterans Way",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977562583",
            "country_code": "US",
            "telephone_number": "541-382-2811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "815 SW Bond St",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977023593",
            "country_code": "US",
            "telephone_number": "541-382-2811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BEND MEMORIAL CLINIC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEND MEMORIAL CLINIC PC DBA SUMMIT HEALTH",
        "enumeration_date": "2019-10-01",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A",
        "authorized_official_last_name": "DOVER",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "541-706-2495"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213243",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bend Memorial Clinic PC dba Summit Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bend Memorial Clinic LLP
• Bend Memorial Clinic PC
• Bend Memorial Clinic PC
• Bend Memorial Clinic PC (Summit Health)
• Bend Memorial Clinic PC
• Bend Memorial Clinic, PC (Summit Health Physician Dispensary)
• Bend Memory Care, LLC (Mt. Bachelor Memory Care)
• Bend Mental Wellness LLC
• Bend Mobile Physical Therapy LLC
• Bend MRI LLC

• Clinical Medical Laboratory in Bend, OR
• Providers in Bend, OR by specialty
• Clinical Medical Laboratory in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.