Individual provider Active NPI

Abby O'Keefe, PA-C

  • Physician Assistant
  • Canby, OR
National Provider Identifier
1003465220
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA213532 Issued in OR
Practice address
1433 SE 1St Ave
Canby, OR 97013
Phone
(503) 525-7600
NPI assigned
Sep 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA213532 OR
Physician Assistant 363A00000X PA213532 OR Primary

Addresses

Primary practice location

1433 SE 1St Ave
Canby, OR 97013

Mailing address

PO Box 6689
Portland, OR 97228-6689
Phone (503) 494-9992

Other practice location 1

4411 SW Vermont St
Portland, OR 97219-1020
Phone (503) 494-9992

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221214000596 OR Practitioner - Physician Assistant 9436583796 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Meridian Park HospitalGroup PAC ID 5092609842, 113 clinicians

Practice addresses (Care Compare)

1433 SE 1St Ave
Canby, OR 97013-6768
Phone (503) 525-7600

19300 SW 65TH Ave
Tualatin, OR 97062-7706
Phone (503) 413-4330

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Portland, OR, CCN 387003
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Legacy Silverton Medical Center Hospital, Silverton, OR, CCN 380029
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7671AZMDPharmacist
PA213532ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Meridian Park Hospital CurrentSince Apr 1, 2025 Accepting new patients

Locations

1433 SE 1st Ave
Canby, OR 97013
Phone (503) 525-7600

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1003465220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6689",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972286689",
            "telephone_number": "503-494-9992",
            "fax_number": "503-494-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 SE 1ST AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "97013",
            "telephone_number": "503-525-7600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4411 SW Vermont St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972191020",
            "country_code": "US",
            "telephone_number": "503-494-9992",
            "fax_number": "503-494-1967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'KEEFE",
        "first_name": "ABBY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA213532",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA213532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canby, OR

Sources for this page

Verify at the official NPI Registry.