PATH TO AWARENESS PC – Psychiatry Physician, NPI 1811484603
Psychiatry Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for PATH TO AWARENESS PC
PO BOX 503010
WHITE CITY, OR 975030813
Phone: (541) 941-7792
Type: Mailing
809, East Jackson Street, Medford, Jackson County, Oregon, 97504, United States
MEDFORD, OR 975046713
Phone: (541) 245-3614
Fax: (541) 245-3549
Type: Location
809 E Jackson St
Medford, OR 975046713
Phone: (541) 245-3614
Fax: (541) 245-3549
Type: Location
2239 NE DOCTORS DR STE 110
BEND, OR 977017185
Phone: (541) 323-8705
Fax: (541) 323-8708
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: 2020-04-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-06-30 (17 days away).
Enrollment records
1
Earliest due date
2026-06-30
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 |
|---|---|---|---|---|
| O20200423003106 | O | Clinic/Group Practice | OR | 2026-06-30 |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
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 97503)
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