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

Mr. John Patrick Tully, PA-C

Individual provider Physician Assistant · NPI 1992964563

Mr. John Patrick Tully, PA-C is a Physician Assistant in Bend, Oregon. Qualified in 1999, 27 years ago. Practices with Bend Memorial Clinic PC, a 226-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon and Utah.

Years since qualifying
27
Licensed in
OR, UT
In the registry since
2008
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

61250 SE Coombs Pl
Bend, OR 97702-3704
Phone: (541) 706-5930
Fax: (541) 706-5931
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1501 Ne Medical Center Dr, Bend, OR 97701-6051 — (541) 382-4900

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence P175245 (OR)
Physician Assistant Taxonomy 363A00000X · Licence 5008334-1206 (UT)

Record details

NPI number1992964563
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 8, 2008
Last updated in NPPESMay 1, 2026
Certification dateMay 1, 2026
Mailing addressPo Box 6048, Bend, OR 97708-6048

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Bend Memorial Clinic Pc — 226 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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