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

Mr. Clyde Terrence Bancroft, PA

Individual provider Physician Assistant · NPI 1841397742

Mr. Clyde Terrence Bancroft, PA is a Physician Assistant in Roseburg, Oregon. Qualified in 2003, 23 years ago. Practices with Centennial Medical Group East LLC, a 63-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
23
Licensed in
OR
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2570 NW Edenbower Blvd Ste 100
Roseburg, OR 97471
Phone: (541) 677-7200
Fax: (541) 229-3362
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA00866 (OR)

Record details

NPI number1841397742
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 20, 2006
Last updated in NPPESFebruary 2, 2011

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 Centennial Medical Group East Llc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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