Individual provider Active NPI

Megan N Stack, FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1033478409
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201250052NP 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
May 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201250052NP OR Primary

Addresses

Primary practice location

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

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-3442

Other practice location 1

1130 NW 22nd Ave
Suite 640
Portland, OR 97210-2900
Phone (503) 229-7976

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120823000338 OR Practitioner - Nurse Practitioner 2567619794 Reassigns benefits to 1 organization
I20170501002053 WA Practitioner - Nurse Practitioner 2567619794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, shared by 3 NPIs, 1,683 clinicians

Practice addresses (Care Compare)

1501 NE Medical Ctr Dr
Bend, OR 97701-6051
Phone (541) 317-4354

301 W Poplar St
Suite 100
Walla Walla, WA 99362-2800
Phone (509) 897-5824

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Salem Hospital Hospital, Salem, OR, CCN 380051

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
201250052NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince May 1, 2017 Accepting new patients
University Professional Services CurrentSince Jan 9, 2017 Accepting new patients
University Professional Services CurrentSince Jan 9, 2017 Accepting new patients
University Professional Services Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

901 E 18th Ave
Eugene, OR 97403
Phone (541) 346-3575

760 Golf View Dr
Unit 200
Medford, OR 97504
Phone (541) 618-4400

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

312 SE Stonemill Dr
Ste 150
Vancouver, WA 98684
Phone (360) 254-2323

301 W Poplar St
Ste 100
Walla Walla, WA 99362
Phone (509) 522-5824

Interoperability endpoints

  • Direct secure messaging: mstack100023@direct.ohsu.edu

Organizations & group practices 4

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 3

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": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1033478409",
    "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": "1130 NW 22nd Ave",
            "address_2": "Suite 640",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972102900",
            "country_code": "US",
            "telephone_number": "503-229-7976",
            "fax_number": "503-274-4867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACK",
        "first_name": "MEGAN",
        "middle_name": "N",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201250052NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.