PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1063705887
Internal Medicine in Medford, OR

Q: What is Providence Health & Services - Oregon's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since May 26, 2011

920 ROYAL AVE, MEDFORD, OR 97504(541) 732-8400(541) 732-8401 Get Directions Write a Review

NPPES record last updated: November 19, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 19, 2025, May 12, 2025, Oct 1, 2020 and 1 more (4 updates tracked since 2020).

On this page

About Providence Health & Services - Oregon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1063705887), doing business as Pmg Medford Physiatry, is a healthcare organization registered as an internal medicine in Medford, Oregon and active in the NPI registry since May 2011. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1063705887

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON

Location Address920 ROYAL AVEMedford, OR 97504-6169

Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6494

Phone(541) 732-8400

Fax(541) 732-8401

Organization SubpartYes

Authorized OfficialDonald Wayne AndersonAssistant Secretary Enrollment · (425) 358-9786

Enumeration DateMay 26, 2011

Last NPPES UpdateNovember 19, 20254 updates tracked since enumeration

NPPES CertifiedNovember 19, 2025

✔ NPI 1063705887 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

920 ROYAL AVE, Medford, OR 97504

Open in Google Maps ↗

Other Names 3

Doing Business AsPmg Medford Physiatry

Doing Business AsPmg South Medford Neurology

Doing Business AsProvidence Medical Group South

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Providence Health & Services - Oregon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

181

Medicare enrollment records show 181 clinicians reassign Medicare billing to Providence Health & Services - Oregon, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 103 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 21

Nurse Practitioner38

Internal Medicine22

Hospitalist21

Family Practice16

Obstetrics/Gynecology11

Pediatric Medicine11

Cardiovascular Disease (Cardiology)9

Clinical Psychologist9

13 other specialties44

Nearest to this location (20)

See all 181

David Arnopole, FNP-C

Nurse Practitioner

NPI 1720647225

920 ROYAL AVE
Medford, OR 97504

(541) 732-8400

✔ PECOS✔ Accepts MedicareSame address

Walter Carlini, MD

Neurology

NPI 1770583338

920 ROYAL AVE
Medford, OR 97504

(541) 732-8400

✔ PECOS✔ Accepts MedicareSame address

Jason Lundy, DO

Pediatric Medicine

NPI 1134864564

840 ROYAL AVE STE 110
Medford, OR 97504

(541) 732-8370

✔ PECOS0.1 mi

Kruthiga Rajasekaran

Pediatric Medicine

NPI 1023798196

840 ROYAL AVE STE 110
Medford, OR 97504

(541) 732-8370

✔ PECOS0.1 mi

Whitney Serafini, PNP

Nurse Practitioner

NPI 1770033474

840 ROYAL AVE STE 110
Medford, OR 97504

(541) 732-8360

✔ PECOS0.1 mi

Elisa Akagi Fukushima, M.D.

Infectious Disease

NPI 1730568080

1698 E MCANDREWS RD STE 160
Medford, OR 97504

(541) 732-6070

✔ PECOS✔ Accepts Medicare0.1 mi

Julian Bell, MD

Pulmonary Disease

NPI 1497840813

1698 E MCANDREWS RD SUITE 400
Medford, OR 97504

(541) 732-7960

✔ PECOS✔ Accepts Medicare0.1 mi

Annemarie Day, MSN, FNP

Nurse Practitioner

NPI 1972639276

1698 E MCANDREWS RD SUITE 400
Medford, OR 97504

(541) 732-7960

✔ PECOS✔ Accepts Medicare0.1 mi

Rebecca Elliott, D.O.

Obstetrics/Gynecology

NPI 1942697669

1698 E MCANDREWS RD STE 350
Medford, OR 97504

(541) 732-7460

✔ PECOS✔ Accepts Medicare0.1 mi

Tracy Haley, MD

General Surgery

NPI 1407943889

1698 E MCANDREWS RD SUITE 160
Medford, OR 97504

(541) 732-7874

✔ PECOS✔ Accepts Medicare0.1 mi

Jason Kuhl, M.D.

Family Practice

NPI 1659449296

1698 E MCANDREWS RD SUITE 300
Medford, OR 97504

(541) 732-7950

✔ PECOS0.1 mi

Siva Rama Krishna Marri, M.D.

Pulmonary Disease

NPI 1366755126

1698 E MCANDREWS RD STE 400
Medford, OR 97504

(541) 732-7960

✔ PECOS0.1 mi

Mark Mason, M.D.

General Surgery

NPI 1336124510

1698 E MCANDREWS RD SUITE 160
Medford, OR 97504

(541) 732-7874

✔ PECOS✔ Accepts Medicare0.1 mi

Thong Bui, MD

Urology

NPI 1073589651

1698 E MCANDREWS RD STE 280
Medford, OR 97504

(541) 204-1699

✔ PECOS✔ Accepts Medicare0.1 mi

Patrick Davol, M.D.

Urology

NPI 1003025875

1698 E MCANDREWS RD STE 280
Medford, OR 97504

(541) 204-1699

✔ PECOS✔ Accepts Medicare0.1 mi

Patricia Reddy, DNP, MSN, CNM, IBCLC

Certified Nurse Midwife (CNM)

NPI 1134242167

940 ROYAL AVE UNIT 350
Medford, OR 97504

(541) 732-7460

✔ PECOS✔ Accepts Medicare0.1 mi

Sandeep Jhajj, M.D

Vascular Surgery

NPI 1174962369

940 ROYAL AVE UNIT 100
Medford, OR 97504

(541) 732-8388

✔ PECOS✔ Accepts Medicare0.1 mi

Michele Dekorte, MD

Internal Medicine

NPI 1912183328

1111 CRATER LAKE AVE
Medford, OR 97504

(541) 732-5000

✔ PECOS✔ Accepts Medicare0.1 mi

Nandita Suresh, MD

Hospitalist

NPI 1417242173

1111 CRATER LAKE AVE
Medford, OR 97504

(541) 732-5000

✔ PECOS✔ Accepts Medicare0.1 mi

Andrew Tang, D.O.

Physical Medicine and Rehabilitation

NPI 1356769798

827 SPRING ST
Medford, OR 97504

(541) 732-8360

✔ PECOS✔ Accepts Medicare0.2 mi

See all 181 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Health & Services - Oregon's NPI number?

The NPI number for Providence Health & Services - Oregon is 1063705887. It was assigned to this organization in the NPPES registry on May 26, 2011. The provider is doing business as PMG Medford Physiatry, PMG South Medford Neurology and Providence Medical Group South.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 920 Royal Ave, Medford, OR 97504. The listed phone number is (541) 732-8400.

What is Providence Health & Services - Oregon's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Providence Health & Services - Oregon enrolled in Medicare?

Yes. Providence Health & Services - Oregon is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Providence Health & Services - Oregon?

According to the CMS Revalidation Reassignment List (October 2026 release), 181 clinicians in 21 Medicare specialties reassign their Medicare billing to Providence Health & Services - Oregon. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (38), Internal Medicine (22) and Hospitalist (21). Of these, 2 practice at this address and 103 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Providence Health & Services - Oregon was last updated on November 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.