Miriam M Kirse, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA195713 Issued in OR

Practice address

2450 SW Perkins Ave
Pendleton, OR 97801-4302

Phone

(541) 966-6638

Fax

(541) 278-8324

NPI assigned

Jun 4, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miriam Moriah Drummond Former name

Electronic endpoints 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

Oregon Health Sciences University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

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

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
• Willamette Valley Medical Center Hospital, McMinnville, OR, CCN 380071
• Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
• Adventist Health Tillamook Hospital, Tillamook, OR, CCN 381317

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.

• Providence Health & Services Oregon

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group NPD
• Praxis Health, PC

  • Multi-Specialty Clinic/Center
  • Bend, OR
  • NPI 1821068164
  Medicare reassignment NPD
• Praxis Health, PC

  • Rural Health Clinic/Center
  • Dallas, OR
  • NPI 1942925326
  NPD
• Providence Health & Services - Oregon

  • Cardiovascular Disease Physician
  • Newberg, OR
  • NPI 1225378615
  NPD
• Providence Health & Services Oregon

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD

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

• Northwest Medical Foundation of Tillamook

  • Land Ambulance
  • Tillamook, OR
  • NPI 1508849407

  Hospital

  Care Compare affiliation
• Northwest Medical Foundation of Tillamook

  • Critical Access Hospital
  • Tillamook, OR
  • NPI 1699146159
  Care Compare affiliation
• Northwest Medical Foundation of Tillamook

  • Rural Health Clinic/Center
  • Tillamook, OR
  • NPI 1841451853

  Hospital

  Care Compare affiliation
• Northwest Medical Foundation of Tillamook

  • Critical Access Hospital
  • Tillamook, OR
  • NPI 1871575225
  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation
• Providence Health & Services - Oregon

  • Clinic/Center
  • Portland, OR
  • NPI 1326272741

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Oregon City, OR
  • NPI 1912282369
  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Newberg, OR
  • NPI 1952482275
  Care Compare affiliation
• Willamette Valley Medical Center LLC

  • General Acute Care Hospital
  • McMinnville, OR
  • NPI 1346269982
  Care Compare affiliation

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1013409135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 SW PERKINS AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978014302",
            "telephone_number": "541-966-6638",
            "fax_number": "541-278-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 SW PERKINS AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978014302",
            "telephone_number": "541-966-6638",
            "fax_number": "541-278-8324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2730 SW Moody Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972015042",
            "country_code": "US",
            "telephone_number": "503-494-3633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRSE",
        "first_name": "MIRIAM",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA195713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdrummond1016459@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "417 SW 117th Ave Ste 200",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972255924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MIRIAM",
            "last_name": "DRUMMOND",
            "middle_name": "MORIAH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ty Kennison
• Case H Ketting, MD
• Nora Kiggins, MA
• Lexus King
• Amity Lorraine Kirkland, D.P.M
• Clinton E Kittrell, MSW
• Jeffrey Alan Kobernik, D.M.D.
• Matthew Alan Kobzeff, CRM
• Natalie M. Kollross, PSY.D.
• Andrew John Koskenmaki, QMHA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.