Individual provider Active NPI

Anthony J Fillmore, MD

  • Surgery Physician
  • Bend, OR
National Provider Identifier
1982680518
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
K5524 Issued in TX
Practice address
1501 NE Medical Center Dr
Bend, OR 97701-6051
Phone
(541) 382-2811
NPI assigned
Dec 15, 2005
Last updated
Jul 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD172665 OR
Surgery Physician 208600000X K5524 TX Primary
Surgery of the Hand (Surgery) Physician 2086S0105X K5524 TX

Addresses

Primary practice location

1501 NE Medical Center Dr
Bend, OR 97701-6051

Mailing address

PO Box 6048
Bend, OR 97708-6048
Phone (541) 382-2811

Other practice location 1

2200 NE Neff Rd Ste 302
Bend, OR 97701-4279
Phone (541) 706-6915

Other identifiers 3

IdentifierTypeStateIssuer
MD172665OtherOROR-LICENSE
150379901MedicaidTX
500687985MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address afillmore12769@directmsg.bmctotalcare.com
Direct Messaging Address afillmore26812@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150729006626 OR Practitioner - General SurgeryPractitioner - Hand Surgery 5496777252 Reassigns benefits to 2 organizations
I20231005002544 TX Practitioner - Hand Surgery 5496777252 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hand Surgery
Education
University of Texas Southwestern Medical School at Dallas, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bsa Physicians Group IncGroup PAC ID 3971748146, 121 clinicians
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

1000 S Coulter St
Suite 100
Amarillo, TX 79106-1781
Phone (806) 212-4701

2200 NE Neff Rd
Bend, OR 97701-4283
Phone (541) 382-4321

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K5524TXMDSurgery of the Hand (Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Feb 20, 2025 Accepting new patients
Arlington Physician Services PA Surgery CurrentSince Sep 11, 2023 Accepting new patients
Bend Memorial Clinic PC Surgery CurrentSince Jul 1, 2015 Accepting new patients
St. Charles Health System, Inc. CurrentSince Feb 20, 2025 Accepting new patients
Bend Memorial Clinic PC CurrentSince Jul 1, 2015 Accepting new patients
Baptist St. Anthony's Hospital Corporation Past Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

29358 Network Pl
Chicago, IL 60673

1303 NE Cushing Dr
Bend, OR 97701
Phone (541) 318-0858

1303 NE Cushing Dr
Ste 200
Bend, OR 97701
Phone (514) 318-0858

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

2200 NE Neff Rd
Bend, OR 97701
Phone (541) 322-2395

2200 NE Neff Rd
Ste 302
Bend, OR 97701
Phone (541) 706-4220

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

480 NE A St
Madras, OR 97741
Phone (541) 475-4800

384 SE Combs Flat Rd
Ste 1200
Prineville, OR 97754
Phone (541) 447-6263

1245 NW 4th St
Ste 101
Redmond, OR 97756

1315 NW 4th St
Redmond, OR 97756
Phone (541) 388-2333

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

Interoperability endpoints

  • Direct secure messaging: afillmore12769@directmsg.bmctotalcare.com
  • Direct secure messaging: afillmore26812@secure.stcharleshealthcare.org
  • Direct secure messaging: tfillmore904648@ahs.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1982680518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6048",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086048",
            "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": "2200 NE Neff Rd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977014279",
            "country_code": "US",
            "telephone_number": "541-706-6915",
            "fax_number": "541-706-6733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FILLMORE",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD172665",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "K5524",
            "primary": true
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "TX",
            "license": "K5524",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OR-LICENSE",
            "identifier": "MD172665",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150379901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500687985",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "afillmore12769@directmsg.bmctotalcare.com",
            "affiliation": "N",
            "address_1": "1501 NE Medical Center Dr",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016051",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "afillmore26812@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2200 NE Neff Rd Ste 302",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977014279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.