ERIC J WATTENBURG MD NPI 1194791640

NPI Information

  • NPI: 1194791640
  • Provider Name: ERIC J WATTENBURG, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3818 SW 21ST ST
    REDMOND, OR
    ZIP 97756
  • Phone: (541) 548-2899

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NPI Details

Eric J Wattenburg, MD is a family medicine in Redmond, OR. The provider is 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. Eric J Wattenburg, MD NPI is 1194791640. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3818 SW 21ST ST
REDMOND, OR
ZIP 97756
Phone: (541) 548-2899
Fax: (541) 504-3781

The NPI 1194791640 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)

The enumeration date for this NPI number is 2/24/2006 and was last updated on 11/12/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineA78764CALIFORNIANo
2207Q00000XFamily MedicineMD29323OREGONYes
3207P00000XEmergency MedicineMD29323OREGONNo
4207Q00000XFamily Medicine6761572IDAHONo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100887743OTHEROREGONMEDICARE RAILROAD
2500608820MEDICAIDOREGON
3OOA787640MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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