Joshua Gietzen, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA184309 Issued in OR

Practice address

1151 N Adair St
Cornelius, OR 97113-8900

Phone

(503) 359-5564

Fax

(503) 357-4371

NPI assigned

May 26, 2016

Last updated

Nov 7, 2017By 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 1

Addresses

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

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgietzen219612@direct.ochin.org
• Direct secure messaging: jgietzen2242588@oc.providencedirect.org

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.

• Providence Health & Services Oregon

  dba Providence Medical Group

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group
• Virginia Garcia Memorial Health Center

  • Federally Qualified Health Center (FQHC)
  • Cornelius, OR
  • NPI 1679528012
  Medicare reassignment
• Providence Health & Services Oregon

  dba Providence Medical Group

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1164623401
  NPD
• Providence Health & Services Oregon

  dba Providence Medical Group

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• Virginia Garcia Memorial Health Center

  • Federally Qualified Health Center (FQHC)
  • Hillsboro, OR
  • NPI 1053859694
  NPD

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1013365469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6149",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970070149",
            "telephone_number": "503-352-8657",
            "fax_number": "503-352-8658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 N ADAIR ST",
            "city": "CORNELIUS",
            "state": "OR",
            "postal_code": "971138900",
            "telephone_number": "503-359-5564",
            "fax_number": "503-357-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIETZEN",
        "first_name": "JOSHUA",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-26",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA184309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fred Meyer
• Fred Meyer Stores Inc (Fred Meyer Pharmacy)
• Catalina M Garcia Alejo, RDH
• Andres Garcia, RPH
• Christopher Gebhardt
• Rajbir Gill
• Merika Dolin Goldstein, FNP, MS
• Zachary Lian Gong
• Rebecca Gray
• Heymi Hamlin

• Medical Physician Assistant in Cornelius, OR
• Providers in Cornelius, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; 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.