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PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1154675411
Hospitalist in Medford, OR

Active since November 07, 2012
1111 CRATER LAKE AVE, MEDFORD, OR 97504(541) 732-5545(541) 732-5548 Get Directions Write a Review

NPPES record last updated: November 19, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 19, 2025, May 12, 2025, Nov 4, 2021 (3 updates tracked since 2021).

About Providence Health & Services - Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES - OREGON (NPI 1154675411), doing business as Providence Medical Group South, is a healthcare organization registered as a hospitalist in Medford, Oregon and active in the NPI registry since November 2012. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1154675411
Entity TypeOrganization
Primary Taxonomy208M00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES - OREGON
Location Address1111 CRATER LAKE AVEMedford, OR 97504-6241
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6271
Phone(541) 732-5545
Fax(541) 732-5548
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secretary Enrollment · (425) 358-9786
Enumeration DateNovember 7, 2012
Last NPPES UpdateNovember 19, 20253 updates tracked since enumeration
NPPES CertifiedNovember 19, 2025
✔ NPI 1154675411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
1111 CRATER LAKE AVE, Medford, OR 97504
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Other Names 2

Doing Business AsProvidence Medical Group South
Doing Business AsProvidence Medical Group - Medford Hospitalists

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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, 38 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
Puneet Bandi, M.D.
Family Practice
NPI 1801030382
1111 CRATER LAKE AVE
Medford, OR 97504
(541) 732-5545
✔ PECOS✔ Accepts MedicareSame address
Shaik Basha, MD
Hospitalist
NPI 1578712378
1111 CRATER LAKE AVE
Medford, OR 97504
(541) 732-5545
✔ PECOS✔ Accepts MedicareSame address
Vipul Mahajan, M.D
Internal Medicine
NPI 1467795864
1111 CRATER LAKE AVE
Medford, OR 97504
(541) 732-5545
✔ PECOS✔ Accepts MedicareSame address
Pankhuri Malhotra, DO
Hospitalist
NPI 1518587187
1111 CRATER LAKE AVE
Medford, OR 97504
(541) 732-5545
✔ PECOS✔ Accepts MedicareSame address
Annabel Walker, DNP
Nurse Practitioner
NPI 1447865464
1111 CRATER LAKE AVE
Medford, OR 97504
(541) 732-5545
✔ PECOS✔ Accepts MedicareSame address
Michele Dekorte, MD
Internal Medicine
NPI 1912183328
1111 CRATER LAKE AVE
Medford, OR 97504
(541) 732-5000
✔ PECOS✔ Accepts MedicareSame address
Amanda Bujaucius, CNM
Certified Nurse Midwife (CNM)
NPI 1891205134
940 ROYAL AVE UNIT 350
Medford, OR 97504
(541) 732-7460
✔ PECOS✔ Accepts MedicareSame address
William Craft, MD
General Surgery
NPI 1689760506
940 ROYAL AVE SUITE 420
Medford, OR 97504
(541) 732-8388
✔ PECOS✔ Accepts MedicareSame address
Timothy Hutchings, DO
Urology
NPI 1144345455
940 ROYAL AVE STE 350
Medford, OR 97504
(541) 732-7460
✔ PECOS✔ Accepts MedicareSame address
Jennifer Jackson, M.D.
Obstetrics/Gynecology
NPI 1174784367
940 ROYAL AVE UNIT 350
Medford, OR 97504
(541) 732-7460
✔ PECOS✔ Accepts MedicareSame address
Jessica Luckman, WHNP
Nurse Practitioner
NPI 1750703559
940 ROYAL AVE STE 350
Medford, OR 97504
(541) 732-7460
✔ PECOS✔ Accepts MedicareSame address
Aaron Partsafas, M.D.
Vascular Surgery
NPI 1578772935
940 ROYAL AVE SUITE 420
Medford, OR 97504
(541) 732-8388
✔ PECOS✔ Accepts MedicareSame address
Hillary Handelsman, CNM, WHNP, NP
Certified Nurse Midwife (CNM)
NPI 1215127519
940 ROYAL AVE UNIT 350
Medford, OR 97504
(541) 732-7460
✔ PECOS✔ Accepts MedicareSame address
Sandeep Jhajj, M.D
Vascular Surgery
NPI 1174962369
940 ROYAL AVE UNIT 100
Medford, OR 97504
(541) 732-8388
✔ PECOS✔ Accepts MedicareSame address
Thong Bui, MD
Urology
NPI 1073589651
1698 E MCANDREWS RD STE 280
Medford, OR 97504
(541) 204-1699
✔ PECOS✔ Accepts MedicareSame address
Elisa Akagi Fukushima, M.D.
Infectious Disease
NPI 1730568080
1698 E MCANDREWS RD STE 160
Medford, OR 97504
(541) 732-6070
✔ PECOS✔ Accepts MedicareSame address
Julian Bell, MD
Pulmonary Disease
NPI 1497840813
1698 E MCANDREWS RD SUITE 400
Medford, OR 97504
(541) 732-7960
✔ PECOS✔ Accepts MedicareSame address
Rebecca Elliott, D.O.
Obstetrics/Gynecology
NPI 1942697669
1698 E MCANDREWS RD STE 350
Medford, OR 97504
(541) 732-7460
✔ PECOS✔ Accepts MedicareSame address
Tracy Haley, MD
General Surgery
NPI 1407943889
1698 E MCANDREWS RD SUITE 160
Medford, OR 97504
(541) 732-7874
✔ PECOS✔ Accepts MedicareSame address
Jason Kuhl, M.D.
Family Practice
NPI 1659449296
1698 E MCANDREWS RD SUITE 300
Medford, OR 97504
(541) 732-7950
✔ PECOSSame address
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 1154675411. It was assigned to this organization in the NPPES registry on November 7, 2012. The provider is doing business as Providence Medical Group South and Providence Medical Group - Medford Hospitalists.

Where is Providence Health & Services - Oregon located?

Providence Health & Services - Oregon is located at 1111 Crater Lake Ave, Medford, OR 97504. The listed phone number is (541) 732-5545.

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

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

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, 38 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.