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DESCHUTES SURGERY CENTER, LLC
NPI 1477949766
Clinic/Center - Ambulatory Surgical in Bend, OR

Active since April 13, 2015CLIA 38D2108343 · Waiver
2115 NE WYATT CT, SUITE 105, BEND, OR 97701(541) 585-2400(541) 585-2415 Get Directions Write a Review

NPPES record last updated: March 21, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Deschutes Surgery Center, Llc NPPES

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

DESCHUTES SURGERY CENTER, LLC (NPI 1477949766) is a healthcare organization registered as an ambulatory surgical in Bend, Oregon and active in the NPI registry since April 2015. The organization holds a CLIA Waiver certificate valid through February 1, 2028 and lists Kimberly M Booher, Administrator, as its authorized official.

NPPES Registry Identity

NPI1477949766
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameDESCHUTES SURGERY CENTER, LLC
Location Address2115 NE WYATT CT, SUITE 105Bend, OR 97701-7678
Mailing Address2115 Ne Wyatt Ct, Suite 105Bend, OR 97701-7678 · (541) 585-2400 · Fax (541) 585-2415
Phone(541) 585-2400
Fax(541) 585-2415
Organization SubpartNo
Authorized OfficialKimberly M BooherAdministrator · (541) 585-2400
Enumeration DateApril 13, 2015
Last NPPES UpdateMarch 21, 2017
✔ NPI 1477949766 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
2115 NE WYATT CT, Bend, OR 97701
Open in Google Maps ↗

Other Names 1

Doing Business AsDeschutes Surgery Center, Llc

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 ›

CLIA Laboratory Certificates CMS CLIA

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 Waiver 38D2108343

Deschutes Surgery Center · Bend, OR
Active · expires Feb 1, 2028
CLIA Number38D2108343
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateFebruary 2, 2026
Certificate Expiration DateFebruary 1, 2028
Laboratory DirectorDr. Philip C. Wallace MD
Laboratory Phone(541) 323-6280
Laboratory LocationDeschutes Surgery Center2115 NE Wyatt Court, Suite 105, Bend, OR 97701
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection of lower or sacral spine facet joint using imaging guidance, single level 64493
This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.
388 services146 patients
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483
This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.
357 services190 patients
Injection of upper or middle spine facet joint using imaging guidance, single level 64490
This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.
219 services82 patients
Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint 64635
This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.
184 services84 patients
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography G0260
This procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.
110 services57 patients
Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level 64479
This procedure involves injecting anesthetic or steroid medication into a specific nerve root in the upper or middle spine. It's performed using imaging technology for precise placement. The aim is to reduce inflammation and alleviate pain.
95 services61 patients

Other Providers at the Same Location NPPES 8

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

MRS. CHRISTINE EMILY KELLER LCSW
Social Worker (Clinical)
2115 NE WYATT CT, SUITE 201
BEND, OR 97701
Deschutes County (541) 647-5226
CENTRAL OREGON SPINE AND SPORTS, LLC
Physical Medicine & Rehabilitation
2115 NE WYATT CT, SUITE 101
BEND, OR 97701
Deschutes County (541) 420-4833
DR. BRADFORD CHARLES DORSAY M.D.
Internal Medicine
2115 NE WYATT CT, SUITE 201
BEND, OR 97701
Deschutes County (541) 382-9110
NORTHWEST MEDICAL SPECIALIST LLC
Neurological Surgery
2115 NE WYATT CT, SUITE #201
BEND, OR 97701
Deschutes County (541) 585-2400
DR. STEPHEN ANDREW ERAKER M.D.
Internal Medicine
2115 NE WYATT CT, BEND VA CLINIC, SUITE 201
BEND, OR 97701
Deschutes County (541) 381-9110
MOUNTAIN VIEW NATUROPATHIC MEDICINE, INC.
Naturopath
2115 NE WYATT CT, SUITE 101
BEND, OR 97701
Deschutes County (541) 249-3626
KRISTINE ANN RAUDY PA-C
Physician Assistant (Medical)
2115 NE WYATT CT, SUITE 201
BEND, OR 97701
Deschutes County (541) 545-2400
DR. DAVID A DONNELLY M.D.
Internal Medicine
2115 NE WYATT CT, SUITE 201
BEND, OR 97701
Deschutes County (541) 382-9110

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 Deschutes Surgery Center, LLC's NPI number?

The NPI number for Deschutes Surgery Center, LLC is 1477949766. It was assigned to this organization in the NPPES registry on April 13, 2015.

Where is Deschutes Surgery Center, LLC located?

Deschutes Surgery Center, LLC is located at 2115 NE Wyatt Ct Suite 105, Bend, OR 97701. The listed phone number is (541) 585-2400.

What is Deschutes Surgery Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Deschutes Surgery Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2108343) is associated with this NPI, valid through February 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Deschutes Surgery Center, LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Deschutes Surgery Center, LLC 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 Deschutes Surgery Center, LLC was last updated on March 21, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.