Duane Charles Wilson (NPI# 1780664664, PAC ID# 0345137907) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1780664664 |
| PAC ID by PECOS | 0345137907 |
| Professional Enrollment ID | I20171005002050 |
| Full Name | Duane Charles Wilson |
| Organization Legal Name | GLENDORA RADIOLOGICAL ASSOC INC |
| Address |
57638 Red Alder Lane Sunriver OR 97707 |
| Phone Number | 6263395464 |
| Gender | M |
| Medical School | LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1982 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 2163514589 |
| Number of Group Practice Members | 38 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 501303 | WILLAPA HARBOR HOSPITAL |
| 450132 | MEDICAL CENTER HOSPITAL |
| 451377 | REEVES COUNTY HOSPITAL DISTRICT |
| 371321 | HOLDENVILLE GENERAL HOSPITAL |
| 030074 | SELLS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 144 Strawberry Ln, Ashland, OR 97520-2754 | 9525951100 | VIRTUAL RADIOLOGIC PROFESSIONALS LLC |
| 60879 Oasis Pl, Bend, OR 97702-3902 | 9525951100 | VIRTUAL RADIOLOGIC PROFESSIONALS LLC |
| Highway 86 At Topawa Rd, Sells Indian Hospital, Sells, AZ 85634 | 5203837285 | TON SELLS HOSPITAL |
| West Hwy 86 Mile Marker 74, San Simon Health Center, Sells, AZ 85634-0000 | 5203627003 | TON SAN SIMON HEALTH CENTER |
| 57638 Red Alder Lane, Sunriver, OR 97707 | 6263395464 | GLENDORA RADIOLOGICAL ASSOC INC |
| 57638 Red Alder Ln, Sunriver, OR 97707 | 9255951100 | VIRTUAL RADIOLOGIC PROFESSIONALS LLC |
| 57638 Red Alder Ln, Sunriver, OR 97707 | 9525951100 | BAY AREA RADIOLOGY PC |
| 7900 S J Stock Rd, San Xavier Health, Tucson, AZ 85746-7012 | 5202952546 | TON SAN XAVIER HEALTH CENTER |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_225_overall | Radiology: Reminder System for Screening Mammograms | 100% |
| Organization Legal Name | GLENDORA RADIOLOGICAL ASSOC INC |
| Physicians | 27 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Douglas James Alden | Diagnostic Radiology | Glendora Radiological Assoc Inc | 373 Big Horn Ridge Dr Ne, Albuquerque, NM 87122-1424 |
| Michael J Grant | Diagnostic Radiology | Glendora Radiological Assoc Inc | 7703 N Warren Ln, Spokane, WA 99208-4978 |
| Eugene T Kim | Diagnostic Radiology | Glendora Radiological Assoc Inc | 20391 W Springfield St, Buckeye, AZ 85396-3544 |
| Jennifer Kim | Diagnostic Radiology | Glendora Radiological Assoc Inc | 35 Deacons Way, New Canaan, CT 06840-4221 |
| Catherine C Roberts | Diagnostic Radiology | Glendora Radiological Assoc Inc | 16236 N 110th St, Scottsdale, AZ 85255-2433 |
| Wendy E Zimmer | Diagnostic Radiology | Glendora Radiological Assoc Inc | 32 Saint Catherines Ct, Buffalo, NY 14222-1614 |
| Bruce J Thaler | Diagnostic Radiology | Glendora Radiological Assoc Inc | 110 S Front St, Philadelphia, PA 19106-3000 |
| Scott C Chang | Diagnostic Radiology | Glendora Radiological Assoc Inc | 8755 Killians Greens Dr, Las Vegas, NV 89131-6706 |
| Albert C Ybasco | Diagnostic Radiology | Glendora Radiological Assoc Inc | 46 Carillon Cir, Livingston, NJ 07039-2600 |
| William F Pfisterer | Interventional Radiology | Glendora Radiological Assoc Inc | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| Street Address |
57638 RED ALDER LANE |
| City | SUNRIVER |
| State | OR |
| Zip | 97707 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Skotte Jr. | Family Medicine | 57067 Beaver Dr, Sunriver, OR 97707 | |
| Brent G Bradley | Physical Therapy | 57067 Beaver Dr, Suite B, Sunriver, OR 97707-2502 |
| City | SUNRIVER |
| Zip Code | 97707 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | SUNRIVER + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Duane Charles Wilson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.