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

NPI Status: Active since April 13, 2015

Contact Information

2115 NE WYATT CT
SUITE 105
BEND, OR
ZIP 97701
Phone: (541) 585-2400
Fax: (541) 585-2415

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 38D2023259
  • CLIA Cert. Type: Other - PSYCHIATRIC CENTER
  • CLIA Exp. Date: 04-18-2027

About DESCHUTES SURGERY CENTER, LLC

This page provides the complete NPI Profile along with additional information for Deschutes Surgery Center, Llc, a provider established in Bend, Oregon operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1477949766 assigned on April 2015. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Deschutes Surgery Center, Llc. The authorized official of this NPI record is Kimberly M Booher Bs (Administrator)

NPI
1477949766
Provider Legal Name
DESCHUTES SURGERY CENTER, LLC
Other Organization Name
DESCHUTES SURGERY CENTER, LLC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2115 NE WYATT CT SUITE 105 BEND, OR 97701
Location Phone
(541) 585-2400
Location Fax
(541) 585-2415
Mailing Address
2115 NE WYATT CT SUITE 105 BEND, OR 97701
Mailing Phone
(541) 585-2400
Mailing Fax
(541) 585-2415
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-13-2015
Last Update Date
03-21-2017
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BridgeSpan Standard Bronze Plan - EPO
  • BridgeSpan Standard Gold Plan - EPO
  • BridgeSpan Standard Silver Plan - EPO
  • Moda Health Affinity Bronze 8000 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Moda Health Oregon Standard Bronze Affinity - EPO
  • Moda Health Oregon Standard Gold Affinity - EPO
  • Moda Health Oregon Standard Silver Affinity - EPO
  • Core Bronze HSA 10600 - EPO
  • Core Bronze HSA 7500 - EPO
  • Core Bronze HSA 8300 - EPO
  • Core Gold 1500 - EPO
  • Core Gold 3000 - EPO
  • Core Silver 3500 - EPO
  • Core Silver 4500 - EPO
  • Core Silver 5000 - EPO
  • Core Silver 7500 - EPO
  • Core Standard Expanded Bronze HSA - EPO
  • Core Standard Gold - EPO
  • Core Standard Silver - EPO
  • PacificSource Oregon Standard Bronze HSA Plan Core - EPO
  • PacificSource Oregon Standard Gold Plan Core - EPO
  • PacificSource Oregon Standard Silver Plan Core - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO
  • Bronze 8000 Individual Connect - EPO
  • Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
  • Bronze HSA 7000 Individual Connect - EPO
  • Gold 2300 Individual Connect - EPO
  • Regence Standard Bronze Plan Individual Connect - EPO
  • Regence Standard Gold Plan Individual Connect - EPO
  • Regence Standard Silver Plan Individual Connect - EPO
  • Silver 6500 Individual Connect - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KIMBERLY M BOOHER BS

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(541) 585-2400

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 25 times for 16 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

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.

This service was performed 205 times for 100 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

This service was performed 86 times for 48 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

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.

This service was performed 406 times for 229 patients

Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level

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.

This service was performed 89 times for 52 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

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.

This service was performed 401 times for 139 patients

Injection of upper or middle spine facet joint using imaging guidance, single level

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.

This service was performed 223 times for 86 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

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.

This service was performed 109 times for 61 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
38D2023259
Facility Type
Other - PSYCHIATRIC CENTER
Certificate Effective Date
April 19, 2025
Certificate Expiration Date
April 18, 2027
Laboratory Director
LORNA ILLINGWORTH
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Deschutes Surgery Center, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1477949766, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 74. The final step is to find the difference between that total and the next multiple of ten (80 - 74 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
7
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
4
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
7
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 9 → 18 → 9 9 → 18 → 9 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 4 + 7 + 1 + 8 + 4 + 1 + 8 + 7 + 1 + 2 + 24 = 74

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 74 is 80. The difference is the calculated check digit.

80 - 74 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1477949766.

Other Providers at the Same Location


The following 8 providers are registered at the same or a nearby location.

Internal Medicine
2115 NE WYATT CT, SUITE 201
BEND, OR 97701
Internal Medicine
2115 NE WYATT CT, SUITE 201
BEND, OR 97701
Internal Medicine
2115 NE WYATT CT, BEND VA CLINIC, SUITE 201
BEND, OR 97701
Social Worker (Clinical)
2115 NE WYATT CT, SUITE 201
BEND, OR 97701
Physical Medicine & Rehabilitation
2115 NE WYATT CT, SUITE 101
BEND, OR 97701
Naturopath
2115 NE WYATT CT, SUITE 101
BEND, OR 97701
Neurological Surgery
2115 NE WYATT CT, SUITE #201
BEND, OR 97701
Physician Assistant (Medical)
2115 NE WYATT CT, SUITE 201
BEND, OR 97701

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1477949766, enumerated as an "organization" on April 13, 2015.

The provider is located at 2115 NE WYATT CT SUITE 105 BEND, OR 97701 and the phone number is (541) 585-2400.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: BridgeSpan Health Company, Moda Health Plan, Inc.,. Please consult your insurance carrier or call the provider to verify.