Individual provider Active NPI

Mahkameh Mehdianrad, PA

  • Physician Assistant
  • Hillsboro, OR
National Provider Identifier
1043530348
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA151769 Issued in OR
Practice address
10690 NE Cornell Rd Ste 220
Hillsboro, OR 97124-9224
Phone
(503) 848-5861
Fax
(503) 848-5863
NPI assigned
Jun 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA151769 OR Primary

Addresses

Primary practice location

10690 NE Cornell Rd Ste 220
Hillsboro, OR 97124-9224

Mailing address

7320 SW Hunziker Rd Ste 300
Portland, OR 97223-2302
Phone (503) 941-3033

Other identifiers 1

IdentifierTypeStateIssuer
500621995MedicaidOR

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
I20101108000336 OR Practitioner - Physician Assistant 0345435111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood Health CenterGroup PAC ID 8426227893, 35 clinicians

Practice addresses (Care Compare)

10690 NE Cornell Rd
Suite 220
Hillsboro, OR 97124-9224
Phone (503) 848-5861

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health Center CurrentSince Jul 1, 2011 Accepting new patients
Neighborhood Health Center Past Accepting new patients
Careoregon Community Health, LLC Past Accepting new patients
Neighborhood Health Center Past Accepting new patients

Locations

227 NW 3rd Ave
Canby, OR 97013
Phone (503) 416-4547

10690 NE Cornell Rd
Ste 220
Hillsboro, OR 97124
Phone (503) 848-5861

6420 S Macadam Ave
Ste 300
Portland, OR 97239
Phone (503) 941-3033

10330 SE 32nd Ave
Ste 325
Portland, OR 97222
Phone (503) 387-8200

7320 SW Hunziker Rd
Ste 300
Tigard, OR 97223
Phone (503) 941-3033

Interoperability endpoints

  • Direct secure messaging: mmehdianrad23991@direct.ochin.org

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 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": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1043530348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 SW HUNZIKER RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972232302",
            "telephone_number": "503-941-3033",
            "fax_number": "503-747-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10690 NE CORNELL RD STE 220",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971249224",
            "telephone_number": "503-848-5861",
            "fax_number": "503-848-5863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHDIANRAD",
        "first_name": "MAHKAMEH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA151769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500621995",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.