Aaron Randy Cooper, PA-C
Individual provider Active NPI Medical Physician Assistant · La Grande, OR
NPI 1013439033 · NPPES record last updated Oct 3, 2023
Key facts
- NPI
- 1013439033
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA195045 (OR)
- Practice address
- 710 Sunset Dr Ste F
La Grande, OR 97850-1200 - Phone
- (541) 663-3100
- Fax
- (541) 975-5135
- NPI assigned
- Jul 11, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grande Ronde Hospital Inc
Practice addresses (Care Compare)
900 Sunset Dr
La Grande, OR 97850-1362
900 Sunset Dr
La Grande, OR 97850-1387
Phone (541) 963-8421
PO Box
La Grande, OR 97850
Hospital & facility affiliations
- Grande Ronde Hospital
- Wallowa Memorial Hospital
- St. Alphonsus Medical Center - Baker City
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.73 of 100
- Quality
- 85.86
- Promoting interoperability
- 99
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171229001428 | NY | Practitioner - Physician Assistant | 3173881828 | Reassigns benefits to 1 organization |
| I20191126000463 | OR | Practitioner - Physician Assistant | 3173881828 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA195045 | OR | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grande Ronde Hospital, Inc. | Current |
Accepting new patients | |
| Grande Ronde Hospital, Inc. | Current |
Accepting new patients | |
| Canton-Potsdam Hospital | Current |
Accepting new patients |
Locations
50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034
201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102
710 Sunset Dr
Ste F
La Grande, OR 97850
Phone (541) 663-3100
900 Sunset Dr
La Grande, OR 97850
Phone (541) 963-8421
Interoperability endpoints
- acooper1142528@wm.providencedirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA195045 | OR | Yes |
Addresses
Primary practice location
710 Sunset Dr Ste F
La Grande, OR 97850-1200
Mailing address
PO Box 3290
La Grande, OR 97850-7290
Phone (541) 663-3100
Other providers in La Grande, OR
- John Lauren Combe
- Comm-Line, Inc.
- Community Connection of Northeast Oregon, Inc.
- Bryan Richard Conklin
- Kerma Luann Cook
- Michelle Coplin
- Shane Lee Coughran
- Robert Browne Coulter
- Lori Crandall
- Lindsay Crawford
All providers in La Grande, OR · Medical Physician Assistant in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.