BEND DERMATOLOGY CLINIC
NPI 1447764741
Dermatology in Bend, OR
About Bend Dermatology Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BEND DERMATOLOGY CLINIC (NPI 1447764741) is a healthcare organization registered as a dermatology in Bend, Oregon and active in the NPI registry since November 2017. The organization holds 7 active CLIA laboratory certificates and lists Bret S Blackhart, Md, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bend Dermatology Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
25Medicare enrollment records show 25 clinicians reassign Medicare billing to Bend Dermatology Clinic, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 3
Nearest to this location (20)
See all 25Clackamas, OR 97015
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 7
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 38D2134456
Bend Dermatology Clinic-Klamath Falls · Klamath Falls, ORCertificate for Provider-Performed Microscopy Procedures (PPMP) 38D2264124
Bend Dermatology Clinic-Prineville · Prineville, ORCertificate of Compliance 38D2052874
Bend Dermatology Clinic-Redmond · Redmond, ORCertificate of Compliance 38D1097454
Bend Dermatology Clinic - Main Lab · Bend, ORCertificate of Compliance 38D1097453
Bend Dermatology Clinic - Mohs · Bend, ORCertificate for Provider-Performed Microscopy Procedures (PPMP) 38D2324839
Bend Dermatology Clinic - Ashland · Ashland, ORFrequently 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 Mountain West Derm - Blackhart PLLC's NPI number?
The NPI number for Mountain West Derm - Blackhart PLLC is 1447764741. It was assigned to this organization in the NPPES registry on November 22, 2017. The provider is doing business as Bend Dermatology Clinic.
Where is Mountain West Derm - Blackhart PLLC located?
Mountain West Derm - Blackhart PLLC is located at 2747 NE Conners Ave, Bend, OR 97701. The listed phone number is (541) 382-5712.
What is Mountain West Derm - Blackhart PLLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Mountain West Derm - Blackhart PLLC enrolled in Medicare?
Yes. Mountain West Derm - Blackhart PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mountain West Derm - Blackhart PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 25 clinicians in 3 Medicare specialties reassign their Medicare billing to Mountain West Derm - Blackhart PLLC. 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 Dermatology (20), Nurse Practitioner (4) and Micrographic Dermatologic Surgery (MDS) (1). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Mountain West Derm - Blackhart PLLC hold CLIA laboratory certificates?
Yes. 7 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Mountain West Derm - Blackhart PLLC accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Mountain West Derm - Blackhart PLLC 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 Mountain West Derm - Blackhart PLLC was last updated on November 22, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.