Active NPI
Jonathan Mang, PA-C
- Physician Assistant
- Albany, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA228152
- Practice address
- 2910 Santiam Hwy SE
Albany, OR 97322-1400 - Phone
- (541) 406-3899
- NPI assigned
- Jan 22, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA228152 | OR | Primary |
Addresses
Primary practice location
2910 Santiam Hwy SE
Albany, OR 97322-1400
Mailing address
2910 Santiam Hwy SE
Albany, OR 97322-1400
Phone (541) 406-3899
Other practice location 1
1700 Geary St SE Ste 400
Albany, OR 97322-6842
Phone (541) 812-5500
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jmang250333@samhealth.direct-ci.com |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1700 Geary St SE
Albany, OR 97322-6842
2910 Santiam Hwy SE
Suite a
Albany, OR 97322-5256
Phone (541) 406-3899
400 Hickory St NW
Albany, OR 97321-1700
534 Pleasant View Way NW
Albany, OR 97321-1700
705 Elm St SW
Suite 200
Albany, OR 97321-1957
Phone (541) 812-4850
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA228152 | OR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icco LLC | Current | Accepting new patients | |
| Icco, LLC | Single Specialty | Current | Accepting new patients |
| Icco, LLC | Single Specialty | Past | Accepting new patients |
Locations
2910 Santiam Hwy SE
Ste A
Albany, OR 97322
Phone (541) 406-3899
598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473
3675 Pacific Ave
#101
Forest Grove, OR 97116
Phone (971) 762-4611
1890 NW 6th St
Grants Pass, OR 97526
Phone (541) 507-0684
3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337
3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605
Organizations & group practices 6
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.
-
- General Acute Care Hospital
- Albany, OR
- NPI 1154372340
-
- General Acute Care Hospital
- Corvallis, OR
- NPI 1962453134
-
- Critical Access Hospital
- Lebanon, OR
- NPI 1689625980
-
- Rural Health Clinic/Center
- Florence, OR
- NPI 1740896547
Hospital & facility affiliations 17
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Albany, OR
- NPI 1154372340
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Albany, OR
- NPI 1326755158
Hospital
-
- Endocrinology, Diabetes & Metabolism Physician
- Albany, OR
- NPI 1346620408
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1003677600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2910 SANTIAM HWY SE",
"city": "ALBANY",
"state": "OR",
"postal_code": "973221400",
"telephone_number": "541-406-3899",
"fax_number": "458-250-6238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2910 SANTIAM HWY SE",
"city": "ALBANY",
"state": "OR",
"postal_code": "973221400",
"telephone_number": "541-406-3899"
}
],
"practiceLocations": [
{
"address_1": "1700 Geary St SE Ste 400",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "OR",
"postal_code": "973226842",
"country_code": "US",
"telephone_number": "541-812-5500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANG",
"first_name": "JONATHAN",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-01-22",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA228152",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmang250333@samhealth.direct-ci.com",
"affiliation": "N",
"address_1": "1700 Geary St SE Ste 400",
"city": "Albany",
"state": "OR",
"country_code": "US",
"postal_code": "973226842",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Albany, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.