Alejandro Elliott Colmenero I, MSPA, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA183504 Issued in OR

Practice address

21 Hayden Bridge Way
Springfield, OR 97477-1305

Phone

(541) 747-4300

Fax

(541) 747-0655

NPI assigned

Apr 20, 2017

Last updated

Jun 2, 2021By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Medical Homes, LLCGroup PAC ID 0042100372, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BEGCAA/Endpoint/BEGCAA
• FHIR API: https://fhir4.healow.com/fhir/r4/BEGCAA

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

• Northwest Medical Homes, LLC

  dba Springfield Family Physicians

  • Family Medicine Physician
  • Springfield, OR
  • NPI 1114974946
  Medicare reassignment Care Compare group
• Northwest Medical Homes, LLC

  dba Centennial Clinic

  • Family Medicine Physician
  • Springfield, OR
  • NPI 1114396199
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Peacehealth

  dba Sacred Heart-RiverBend

  • General Acute Care Hospital
  • Springfield, OR
  • NPI 1083888515
  Care Compare affiliation
• Peacehealth

  • Psychiatric Hospital Unit
  • Eugene, OR
  • NPI 1568236974
  Care Compare affiliation

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1003340613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 MARCOLA RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974772594",
            "telephone_number": "541-747-4300",
            "fax_number": "541-747-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HAYDEN BRIDGE WAY",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771305",
            "telephone_number": "541-747-4300",
            "fax_number": "541-747-0655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2280 Marcola Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974772594",
            "country_code": "US",
            "telephone_number": "541-747-0655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Centennial Blvd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974774379",
            "country_code": "US",
            "telephone_number": "541-747-4300",
            "fax_number": "541-747-0655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLMENERO",
        "first_name": "ALEJANDRO",
        "middle_name": "ELLIOTT",
        "name_suffix": "I",
        "credential": "MSPA, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA183504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500726848",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony N Colley, RN
• Kristin Collier
• Chase Michael Collings
• Madison Paige Collins, BSN, RN, CEN
• Serina M. Collins, MA
• Jessica Marie Colon, FNP-C
• Columbacare Services (Summit Residential South)
• Columbiacare Services
• Columbiacare Services
• Community Health Centers of Lane County

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.