<unavail> in Pendleton, OR - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Pendleton, Oregon. The current practice location for is 1100 Southgate Ste 2, Pendleton, Oregon. For appointments, you can reach them via phone at (541) 215-1564. The mailing address for is Po Box 1125, Pendleton, Oregon and phone number is (541) 215-1564.

is licensed to practice in Oregon (license number MD29141). The clinic also participates in the medicare program and its NPI number is 1154764405. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (541) 215-1564.

Contact Information


	1100 Southgate Ste 2 Pendleton OR 97801-3971
	(541) 215-1564
	(541) 215-1567

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	1100 Southgate Ste 2, Pendleton, Oregon
Authorized Official Name and Position	Russell B Harrison (OWNER/OPERATOR)
Authorized Official Contact	5412151564
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Po Box 1125 Pendleton OR 97801-0100 Ph: (541) 215-1564	1100 Southgate Ste 2 Pendleton OR 97801-3971 Ph: (541) 215-1564

NPI Details:

NPI Number	1154764405
Provider Enumeration Date	04/16/2013
Last Update Date	01/27/2021

Medicare PECOS Information:

Medicare PECOS PAC ID	1850530841
Medicare Enrollment ID	O20130624000580

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154764405	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QP2300X	Clinic/center - Primary Care	MD29141 (Oregon)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Russell B Harrison
Provider Type	Practitioner - Family Practice
Provider Identifiers	NPI Number: 1164409173 PECOS PAC ID: 7315096047 Enrollment ID: I20090617000600

Provider Name	Andrea Yolanda Carrasco
Provider Type	Practitioner - Family Practice
Provider Identifiers	NPI Number: 1427023621 PECOS PAC ID: 9032242870 Enrollment ID: I20190719001285

Reviews and Comments

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- Medicare Primary Care in Pendleton, OR