PONY CREEK ANNEX LLC NPI 1538736459

NPI Information

  • NPI: 1538736459
  • Provider Name: PONY CREEK ANNEX, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Address: 2075 PUBLIC SQUARE COURT
    NORTH BEND, OR
    ZIP 97459
  • Phone: (541) 297-9551

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NPI Details

PONY CREEK ANNEX, LLC is an ambulatory surgical clinic center in North Bend, OR. PONY CREEK ANNEX, LLC NPI is 1538736459. The provider is registered as an organization entity type.

The provider's business location address is:

2075 PUBLIC SQUARE COURT
NORTH BEND, OR
ZIP 97459-270
Phone: (541) 297-9551

The provider's authorized official is Jane Gilbert .
The authorized official title is Medical Director and has the following contact phone number (541) 297-9551.

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.

  • Removal of cataract with insertion of prosthetic lens (HCPCS:66984)
  • Complex removal of cataract with insertion of prosthetic lens (HCPCS:66982)

The enumeration date for this NPI number is 6/9/2021 and was last updated on 6/9/2021.

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
1261QA1903XClinic/CenterAmbulatory SurgicalYes

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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