James Francis Deitle, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

153509 Issued in OR

Practice address

501 N Graham St
Suite #580
Portland, OR 97227-1654

Phone

(503) 528-0704

Fax

(503) 528-0708

NPI assigned

Sep 5, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tanana Chiefs Conference

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1821201278

  TX

  Medicare reassignment NPD
• Pacific Surgical PC

  • Specialist
  • Portland, OR
  • NPI 1396792990
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295654400000",
    "number": "1003000753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "SUITE #580",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271654",
            "telephone_number": "503-528-0704",
            "fax_number": "503-528-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "SUITE #580",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271654",
            "telephone_number": "503-528-0704",
            "fax_number": "503-528-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEITLE",
        "first_name": "JAMES",
        "middle_name": "FRANCIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2011-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "153509",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deirdre Froehlich DMD LLC
• Kate Benedict Deisseroth, MD
• Howard Lawrence Deitch, PH.D.
• Brenda Marie Deitering
• Paul J Deitering, PA-C
• Megan Dejana, D.C.
• Grace Dejarnette, LCSW
• Anthony Douglas Dejesus, SUDPT, CADC-R
• Cambrynne Dejong
• Jessica Anne Dejong, PA-C

• Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.