SOUTHERN OREGON ORTHOPEDICS INC – Orthopaedic Surgery Physician, NPI 1518093376
Orthopaedic Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SOUTHERN OREGON ORTHOPEDICS INC
2780 E BARNETT RD
SUITE 200
MEDFORD, OR 975048674
Phone: (541) 779-6250
Fax: (541) 772-2531
Type: Mailing
1780 Nebraska Ave
Grants Pass, OR 975275700
Phone: (541) 472-0603
Fax: (541) 472-0609
Type: Location
2780 E BARNETT RD STE 200
MEDFORD, OR 975048674
Phone: (541) 779-6250
Fax: (541) 608-2535
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-11-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-11-30 (190 days ago).
Enrollment records
2
Earliest due date
2025-11-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20031202000214 | O | Clinic/Group Practice | OR | TBD |
| O20141111002188 | O | Physician - Orthopedic/Orthopedic Surgery | OR | 2025-11-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97504)
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