JOSEPH L. PETRUSEK, M.D., P.C. (NPI# 1164553285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164553285 |
| Entity Type | Organization |
| Organization Name | JOSEPH L. PETRUSEK, M.D., P.C. |
| Practice Address |
710 Sunset Dr Ste. D La Grande OR 97850-1200 |
| Practice Telephone | 5419638643 |
| Practice Fax Number | 5419635845 |
| Mailing Telephone | 5419638643 |
| Mailing Fax Number | 5419635845 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOSEPH LOUIS PETRUSEK (OWNER) |
| Authorized Official Telephone | 5419638643 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | MD09444 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 161026 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | JOSEPH L. PETRUSEK, M.D., P.C. | 710 Sunset Drive, Suite D, Lagrande, OR 97850 |
| Street Address |
710 SUNSET DR STE. D |
| City | LA GRANDE |
| State | OR |
| Zip Code | 97850-1200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003816752 | Michael Joseph Sturmak | Audiologist-Hearing Aid Fitter | 710 Sunset Dr, La Grande, OR 97850-1200 | 2005-07-22 |
| 1417483553 | Macey Clark | Nurse Practitioner | 710 Sunset Dr, Suite E, La Grande, OR 97850-1200 | 2017-05-10 |
| 1972046787 | Audiology and Hearing Aid Associates | Audiologist | 710 Sunset Dr, Suite D, La Grande, OR 97850-1200 | 2016-11-28 |
| 1912366543 | Monica A Hill | Nurse Practitioner | 710 Sunset Dr, Pediatrics Suite, La Grande, OR 97850-1200 | 2016-02-10 |
| 1205276003 | Jeanna Romer | Student in an Organized Health Care Education/Training Program | 710 Sunset Dr, La Grande, OR 97850-1200 | 2013-06-26 |
| 1467618280 | Adrian Thomas Davis | Orthopaedic Surgery | 710 Sunset Dr, Suite F, La Grande, OR 97850-1200 | 2008-07-31 |
| 1013194950 | John Schaefer Md PC | Family Medicine | 710 Sunset Dr, Suite C, La Grande, OR 97850-1200 | 2008-01-23 |
| 1265619233 | Kim R. Montee, M.d., P.C. | Family Medicine | 710 Sunset Dr, Suite C, La Grande, OR 97850-1200 | 2008-01-22 |
| 1346297793 | Joseph Louis Petrusek | Otolaryngology | 710 Sunset Dr, Ste. D, La Grande, OR 97850-1200 | 2006-05-30 |
| 1558325886 | Daniel Wayne Hamre | Surgery | 710 Sunset Dr, Suite F, La Grande, OR 97850-1200 | 2006-04-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336749621 | Praxis Medical Group P.C. | Clinic/Center | 2011 Fourth St., La Grande, OR 97850 | 2020-10-27 |
| 1730794637 | Praxis Medical Group Inc | Clinic/Center | 2011 4th Street, La Grande, OR 97850 | 2020-09-09 |
| 1154956233 | Ellen Faye Barlow | Nurse Practitioner | 506 Fourth St., La Grande, OR 97850 | 2020-03-09 |
| 1811479991 | Kyle Jacob Roxby | Pharmacist | 2122 Island Avenue, #201, La Grande, OR 97850 | 2018-09-05 |
| 1093296519 | Grande Ronde Hospital, Inc. | Clinic/Center | 10303 S Walton Rd, La Grande, OR 97850 | 2018-08-23 |
| 1073050795 | Dana Marie Gaerke | Occupational Therapist | Parkway Therapies: La Grande Health and Rehab, 91 Aires Lane, La Grande, OR 97850 | 2017-01-20 |
| 1114393998 | Rachel Marie Gazeley | Dental Hygienist | 1507 4th Street, La Grande, OR 97850 | 2015-08-17 |
| 1104227297 | Sarah Blackwood | Pharmacist | 2212 Island Ave, La Grande, OR 97850 | 2014-09-09 |
| 1669890158 | Jean Mckern | Counselor | 902-a Sixth Street, La Grande, OR 97850 | 2014-04-01 |
| 1629333976 | Robert Caleb Mcilmoil | Physical Therapist | 570 8th Street, Eligin, OR 97850 | 2012-07-11 |
| Find all providers in zip 97850 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245612589 | Steven K Pinther | Otolaryngology | 710 Sunset Dr Ste F, La Grande, OR 97850-1200 | 2015-06-23 |
| 1346297793 | Joseph Louis Petrusek | Otolaryngology | 710 Sunset Dr, Ste. D, La Grande, OR 97850-1200 | 2006-05-30 |
| 1467443515 | Gerry F Funk | Otolaryngology | 710 Sunset Dr Ste F, La Grande, OR 97850 | 2005-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1104289933 | Ci An Gerald Tay | Otolaryngology | 3181 Sw Sam Jackson Park Rd, Pv01, Portland, OR 97239 | 2016-03-30 |
| 1922471291 | Caitlin Bertelsen | Otolaryngology | 3303 Sw Bond Ave Ste 15, Portland, OR 97239-4501 | 2015-11-08 |
| 1326467812 | Tyler Scott Weaver | Otolaryngology | 1508 Division St Ste 115, Oregon City, OR 97045-1584 | 2014-04-10 |
| 1013286822 | Lawrence Thomas Eschelman | Otolaryngology | 3585 Cherokee Dr S, Salem, OR 97302-9712 | 2011-12-22 |
| 1962708578 | John A Lindgren, Md PC | Otolaryngology | 9155 Sw Barnes Rd Ste 401, Portland, OR 97225-6631 | 2011-01-28 |
| 1558674861 | Lucas Rein Rudmik | Otolaryngology | 3720 Sw Bond Ave Unit 2210, Portland, OR 97239-4577 | 2010-07-16 |
| 1134447741 | Aleen J Lee | Otolaryngology | 9280 Se Sunnybrook Blvd Ste 300, Clackamas, OR 97015 | 2010-05-06 |
| 1811164262 | Carrie Maiorana Brown | Otolaryngology | 24076 Se Stark St Ste 230, Gresham, OR 97030 | 2008-05-14 |
| 1114193448 | Ryan Jeffrey Li | Otolaryngology | 3181 Sw Sam Jackson Park Rd # 01, Portland, OR 97239-3011 | 2008-05-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.