Shannon Fay, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA01170 Issued in OR

Practice address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Phone

(503) 494-3442

Fax

(503) 494-5330

NPI assigned

Dec 8, 2006

Last updated

Dec 29, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

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 2

Specialty

Physician Assistant

Education

Oregon Health Sciences University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
• Mid-Columbia Medical Center Hospital, The Dalles, OR, CCN 380001

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: sfaypa75264@direct.ohsu.edu

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.

• University Professional Services

  dba University Professional Services in SW Washington

  • Clinic/Center
  • Vancouver, WA
  • NPI 1881848307
  Medicare reassignment Care Compare group NPD
• Mid-Columbia Medical Center

  dba Adventist Health Columbia Gorge

  • General Practice Physician
  • The Dalles, OR
  • NPI 1053409599
  Medicare reassignment NPD
• University Professional Services

  • General Practice Physician
  • Portland, OR
  • NPI 1376709535
  Medicare reassignment
• Mid-Columbia Medical Center

  dba Adventist Health Columbia Gorge

  • Rural Health Clinic/Center
  • The Dalles, OR
  • NPI 1871833772
  NPD
• University Professional Services

  dba OHSU Home Infusion Pharmacy

  • Pharmacy
  • Beaverton, OR
  • NPI 1073054714
  NPD
• University Professional Services

  dba University Professional Service PLC-013

  • General Practice Physician
  • Bend, OR
  • NPI 1922255074
  NPD
• Mid-Columbia Medical Center

  dba Adventist Health Columbia Gorge

  • Rural Health Clinic/Center
  • The Dalles, OR
  • NPI 1154351336

  Physician Assistant

  NPD (past)
• University Professional Services

  dba University Professional Services in Medford

  • Pediatrics Physician
  • Medford, OR
  • NPI 1225282122
  NPD (past)
• Willamette Family Medical Center Inc

  • Family Medicine Physician
  • Salem, OR
  • NPI 1649386418
  NPD (past)
• Willamette Family Medical Center, Inc

  • Family Medicine Physician
  • Falls City, OR
  • NPI 1043483886
  NPD (past)

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

• Mid-Columbia Medical Center

  dba Adventist Health Columbia Gorge

  • Critical Access Hospital Clinic/Center
  • The Dalles, OR
  • NPI 1306842752
  Care Compare affiliation
• Oregon Health & Science University

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1609824010
  Care Compare affiliation

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1023177565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-3442",
            "fax_number": "503-494-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-3442",
            "fax_number": "503-494-5330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Lancaster Dr NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973012762",
            "country_code": "US",
            "telephone_number": "503-585-6388",
            "fax_number": "503-566-0212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAY",
        "first_name": "SHANNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01170",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA01170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Wesley Fawell, MD
• Fawn and Yarrow Counseling LLC
• Sarah Paul Fawver, RDH
• Holly A Fay, FNP
• Kristen Fay, R.T. (R)
• Katharine Elizabeth Fazal, LMFT
• Hannah Fazendin, LMT
• Sergio Fazio, MD, PHD
• Erica Bernadette Fazzini, PA-C
• FDS Alliance Residential LLC

• Medical Physician Assistant in Portland, OR
• Providers in Portland, 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 Dec 29, 2020; 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.