Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Julianna Ruotolo

Individual provider Physician Assistant · NPI 1386419745

Julianna Ruotolo is a Physician Assistant in Bend, Oregon. Qualified in 2024, 2 years ago. Practices with Icco LLC, a 133-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
2
Licensed in
OR
In the registry since
2023
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Practice location Address checks out

2200 NE Neff Rd Ste 302
Bend, OR 97701-4279
Phone: (541) 706-4200
Fax: (541) 797-5820
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3818 Sw 21st St Ste 100, Redmond, OR 97756-6802 — (541) 548-2899

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 222430 (OR)

Record details

NPI number1386419745
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 16, 2023
Last updated in NPPESApril 16, 2026
Certification dateApril 16, 2026
Mailing address3818 Sw 21st St Ste 100, Redmond, OR 97756-6802

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Icco Llc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations9 on file with Medicare

Other providers in Bend