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JAMES PATRICK PETRUSICH DOCTOR OF AUDIOLOGY
NPI 1073870689
Audiologist in The Dalles, OR

Active since April 19, 2012
1815 E 19TH ST, SUITE 1, THE DALLES, OR 97058(541) 298-8676(541) 298-7746 Get Directions Write a Review

NPPES record last updated: May 9, 2016. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 9, 2016, Mar 29, 2016 (2 updates tracked since 2016).

About James Patrick Petrusich Doctor Of Audiology NPPES

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

JAMES PATRICK PETRUSICH DOCTOR OF AUDIOLOGY (NPI 1073870689) is an individual audiologist in The Dalles, Oregon, licensed in Oregon (23599) and active in the NPI registry since April 2012.

NPPES Registry Identity

NPI1073870689
Entity TypeIndividualMale
Primary Taxonomy231H00000X
Provider Legal NameJAMES PATRICK PETRUSICHCredential: DOCTOR OF AUDIOLOGY
Location Address1815 E 19TH ST, SUITE 1The Dalles, OR 97058-3385
Mailing Address1815 E 19th St, Suite 1The Dalles, OR 97058-3385 · (541) 298-8676 · Fax (541) 298-7746
Phone(541) 298-8676
Fax(541) 298-7746
Sole ProprietorNo
Enumeration DateApril 19, 2012
Last NPPES UpdateMay 9, 20162 updates tracked since enumeration
✔ NPI 1073870689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAudiologistSpeech, Language and Hearing Service Providers
Taxonomy Code231H00000X
License✔ Licensed in OR · 23599
Definition
(1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master's degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy.
1815 E 19TH ST, The Dalles, OR 97058
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Other Identifiers 2

Medicare PINIM673ZFL
OtherP01627946FL · Rr Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

James Patrick Petrusich Doctor Of Audiology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show James Petrusich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mid-Columbia Medical Center
Same address
Multi-Specialty
1825 E 19TH ST
The Dalles, OR 97058
  • Reassigned Medicare billing, Oregon enrollment
  • 195 clinicians in this Medicare group
NPI 1992094817 (541) 506-6920

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

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PROVIDENCE HEALTH & SERVICES - OREGON
Otolaryngology
1815 E 19TH ST, SUITE 1
THE DALLES, OR 97058
Wasco County (541) 298-5563
MR. JAMES L FERRER
Hearing Instrument Specialist
1815 E 19TH ST
THE DALLES, OR 97058
Wasco County (541) 298-8676
COLUMBIA GORGE ENT, LLC
Otolaryngology
1815 E 19TH ST, SUITE 1
THE DALLES, OR 97058
Wasco County (541) 298-5563
DR. CHARLES R FORD MD
Otolaryngology
1815 E 19TH ST, SUITE 1
THE DALLES, OR 97058
Wasco County (541) 298-5563
MATTHEW DAVID PROCTOR MD
Otolaryngology
1815 E 19TH ST, STE 1
THE DALLES, OR 97058
Wasco County (541) 298-5563

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 James Petrusich's NPI number?

The NPI number for James Petrusich is 1073870689. It was assigned to this individual provider in the NPPES registry on April 19, 2012.

Where is James Petrusich located?

James Petrusich practices at 1815 E 19th St Suite 1, The Dalles, OR 97058. The listed phone number is (541) 298-8676.

What is James Petrusich's specialty?

The primary specialty registered for this NPI is Audiologist with taxonomy code 231H00000X.

Is James Petrusich enrolled in Medicare?

Yes. James Petrusich is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for James Petrusich's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Petrusich reassigns Medicare benefits to Mid-Columbia Medical Center (The Dalles, OR). The 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 James Petrusich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Petrusich accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list James Petrusich as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for James Petrusich was last updated on May 9, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.