Individual provider Active NPI

Angela Victoria Lewis, PA

  • Medical Physician Assistant
  • Portland, OR
National Provider Identifier
1023079332
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA167469 Issued in OR
Practice address
10000 SE Main St Ste 60
Portland, OR 97216
Phone
(503) 257-0959
Fax
(503) 257-3457
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 C0003171 MD
Medical Physician Assistant 363AM0700X PA167469 OR Primary

Addresses

Primary practice location

10000 SE Main St Ste 60
Portland, OR 97216

Mailing address

10000 SE Main St Ste 60
Portland, OR 97216-2474
Phone (503) 257-0959

Other practice location 1

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 521-5973

Other names 1

  • Angela Victoria Burch Former name

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
I20150217000987 OR Practitioner - Physician Assistant 1355368564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland Adventist Medical CenterGroup PAC ID 3274908819, 273 clinicians

Practice addresses (Care Compare)

10000 SE Main St
Portland, OR 97216-2474

10123 SE Market St
Portland, OR 97216-2532
Phone (503) 251-6136

10151 SE Sunnyside Rd
Suite 100
Clackamas, OR 97015-5705
Phone (503) 659-0880

2700 SE Stratus Ave
Unit 406
McMinnville, OR 97128-6258
Phone (503) 435-1200

Hospital & facility affiliations

  • Adventist Health Portland Hospital, Portland, OR, CCN 380060

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0003171MDMDMedical Physician Assistant
PA167469ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Adventist Medical Center CurrentSince Jul 8, 2023 Accepting new patients

Locations

10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880

14450 SE Royer Rd
Damascus, OR 97089
Phone (503) 658-5521

2700 SE Stratus Ave
McMinnville, OR 97128
Phone (503) 435-1200

2700 SE Stratus Ave
Unit 406
McMinnville, OR 97128
Phone (503) 435-1200

10000 SE Main St
Ste 60
Portland, OR 97216
Phone (503) 257-0959

Interoperability endpoints

  • Direct secure messaging: alewis154605@direct.ohsu.edu

Organizations & group practices 1

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 1

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023079332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST STE 60",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162474",
            "telephone_number": "503-257-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST STE 60",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97216",
            "telephone_number": "503-257-0959",
            "fax_number": "503-257-3457"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5401 Old Court Rd",
            "address_purpose": "LOCATION",
            "city": "Randallstown",
            "state": "MD",
            "postal_code": "211335103",
            "country_code": "US",
            "telephone_number": "410-521-5973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ANGELA",
        "middle_name": "VICTORIA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0003171",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA167469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "BURCH",
            "middle_name": "VICTORIA",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.