1. Home
  2. Directory
  3. Oregon
  4. Medford
  5. Family Medicine
  6. NPI Profile

PROVIDENCE HEALTH & SERVICES OREGON
NPI 1568547503
Family Medicine in Medford, OR

Active since October 26, 2006
965 ELLENDALE DR, MEDFORD, OR 97504(541) 732-6000(541) 732-6005 Get Directions Write a Review

NPPES record last updated: November 19, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 19, 2025, May 12, 2025, Feb 14, 2022 and 2 more (5 updates tracked since 2019).

About Providence Health & Services Oregon NPPES

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

PROVIDENCE HEALTH & SERVICES OREGON (NPI 1568547503), doing business as Providence Medical Group South, is a healthcare organization registered as a family medicine in Medford, Oregon and active in the NPI registry since October 2006. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1568547503
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES OREGON
Location Address965 ELLENDALE DRMedford, OR 97504-8215
Mailing AddressPo Box 31001 - 4180Pasadena, CA 91110-4180 · (503) 215-6494
Phone(541) 732-6000
Fax(541) 732-6005
Organization SubpartYesParent: Providence Health & Services Oregon
Authorized OfficialDonald Wayne AndersonAssistant Secretary Enrollment · (425) 358-9786
Enumeration DateOctober 26, 2006
Last NPPES UpdateNovember 19, 20255 updates tracked since enumeration
NPPES CertifiedNovember 19, 2025
✔ NPI 1568547503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedPsychiatry & Neurology · Child & Adolescent PsychiatryTaxonomy 2084P0804X
Also ListedPsychiatry & Neurology · Geriatric PsychiatryTaxonomy 2084P0805X
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X
965 ELLENDALE DR, Medford, OR 97504
Open in Google Maps ↗

Other Names 1

Doing Business AsProvidence Medical Group South

Other Identifiers 2

Medicaid288515OR
OtherCG6801OR · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.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)

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, 9 practice at this address and 106 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
Daniel Brandenburg, MD
Internal Medicine
NPI 1255427290
965 ELLENDALE DR
Medford, OR 97504
(541) 732-6000
✔ PECOS✔ Accepts MedicareSame address
Andrean Gurov, MD
Internal Medicine
NPI 1972551703
965 ELLENDALE DR
Medford, OR 97504
(541) 732-6000
✔ PECOS✔ Accepts MedicareSame address
Rupinder Heer, PHD
Clinical Psychologist
NPI 1538837687
965 ELLENDALE DR
Medford, OR 97504
(541) 732-6000
✔ PECOS✔ Accepts MedicareSame address
Andrew Kim, MD
Internal Medicine
NPI 1376639245
965 ELLENDALE DR
Medford, OR 97504
(541) 732-6000
✔ PECOS✔ Accepts MedicareSame address
Travis Mcneal, M.D.
Internal Medicine
NPI 1356437230
965 ELLENDALE DR
Medford, OR 97504
(541) 734-3430
✔ PECOS✔ Accepts MedicareSame address
Lindsey Patterson, RD
Registered Dietitian or Nutrition Professional
NPI 1548818180
965 ELLENDALE DR
Medford, OR 97504
(541) 732-6000
✔ Accepts MedicareSame address
Subhechchha Shah, MD
Family Practice
NPI 1245595206
965 ELLENDALE DR
Medford, OR 97504
(541) 732-6000
✔ PECOS✔ Accepts MedicareSame address
Jayrus Francis Soliman, M.D.
Internal Medicine
NPI 1245598416
965 ELLENDALE DR
Medford, OR 97504
(541) 732-6000
✔ PECOS✔ Accepts MedicareSame address
Todd Winter, MD
Internal Medicine
NPI 1184621559
965 ELLENDALE DR
Medford, OR 97504
(541) 734-3430
✔ PECOS✔ Accepts MedicareSame address
Nicolette Cortez, DNP
Nurse Practitioner
NPI 1194356006
1609 E BARNETT RD
Medford, OR 97504
(541) 450-9792
✔ PECOS0.1 mi
Daniel Coontz, NP
Nurse Practitioner
NPI 1063901007
2780 E BARNETT RD
Medford, OR 97504
(541) 779-6250
✔ PECOS✔ Accepts Medicare0.6 mi
Ahsan Jaffar, MD
Internal Medicine
NPI 1235323619
2825 E BARNETT RD
Medford, OR 97504
(541) 282-6770
✔ PECOS✔ Accepts Medicare0.8 mi
Ekaterina Alchits, M.D.
Hospitalist
NPI 1922449081
2825 E BARNETT RD
Medford, OR 97504
(541) 282-6770
✔ PECOS✔ Accepts Medicare0.8 mi
Minal Jaju, MD
Hospitalist
NPI 1427491620
2825 E BARNETT ROAD
Medford, OR 97504
(541) 282-6770
✔ PECOS✔ Accepts Medicare0.8 mi
Chella Bhagyam, DO
Sports Medicine
NPI 1255836128
70 BOWER DR STE 240
Medford, OR 97501
(541) 732-8790
✔ PECOS✔ Accepts Medicare0.8 mi
Carissa Bravo, PSYD
Clinical Psychologist
NPI 1538562749
70 BOWER DR
Medford, OR 97501
(541) 734-3430
✔ PECOS✔ Accepts Medicare0.8 mi
Uzomechine Chiedozi, MD
Family Practice
NPI 1699160903
70 BOWER DR
Medford, OR 97501
(541) 734-3430
✔ PECOS✔ Accepts Medicare0.8 mi
Aaron Dam, M.D.
Family Practice
NPI 1851826937
70 BOWER DR
Medford, OR 97501
(541) 734-3430
✔ PECOS✔ Accepts Medicare0.8 mi
Carrie Lambourne, MS, RDN, CNSC
Registered Dietitian or Nutrition Professional
NPI 1437969094
70 BOWER DR
Medford, OR 97501
(541) 734-3430
✔ Accepts Medicare0.8 mi
Pratibha Seshadri, M.D
Infectious Disease
NPI 1801143615
691 MURPHY RD
Medford, OR 97504
(541) 789-4505
✔ PECOS✔ Accepts Medicare0.9 mi
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 1568547503. It was assigned to this organization in the NPPES registry on October 26, 2006. The provider is doing business as Providence Medical Group South.

Where is Providence Health & Services Oregon located?

Providence Health & Services Oregon is located at 965 Ellendale Dr, Medford, OR 97504. The listed phone number is (541) 732-6000.

What is Providence Health & Services Oregon's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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, 9 practice at this address and 106 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Providence Health & Services Oregon accept?

Health plans from Moda Health Plan, Inc. and Providence Health Plan list Providence Health & Services Oregon 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 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.