Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Audra Jo Burdulis, PA-C

Individual provider Medical Physician Assistant · NPI 1124075205

Audra Jo Burdulis, PA-C is a Physician Assistant in Bend, Oregon. Qualified in 2003, 23 years ago. Practices with Icco LLC, a 133-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Oregon and Washington.

Years since qualifying
23
Licensed in
OR, WA
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

108 NW Sisemore St Ste 120
Bend, OR 97703-2869
Phone: (541) 213-2133
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 7203 129th Ave Se Ste 100, Newcastle, WA 98056-1412 — (425) 690-3455
  • 3600 Lind Ave Sw Ste 170, Renton, WA 98057-4934 — (425) 690-3555

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA228080 (OR)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA10004625 (WA)

Record details

NPI number1124075205
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 27, 2006
Last updated in NPPESMarch 20, 2026
Certification dateMarch 20, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Icco Llc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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