NPIMap

Individual provider Active NPI

Reda Tawfik Bassaly, PA-C

  • Medical Physician Assistant
  • Lebanon, OR
National Provider Identifier
1043551930
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA163414 Issued in OR
Practice address
325 Park St
Lebanon, OR 97355-4229
Phone
(541) 451-7200
NPI assigned
Mar 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA163414 OR
Medical Physician Assistant 363AM0700X PA163414 OR Primary

Addresses

Primary practice location

325 Park St
Lebanon, OR 97355-4229

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

9800 SE Sunnyside Rd
Clackamas, OR 97015-9750
Phone (503) 813-2000

Other practice location 2

675 N 5th St Ste 200
Lebanon, OR 97355-2875
Phone (541) 451-6282

Other identifiers 2

IdentifierTypeStateIssuer
2035614MedicaidWA
500657182MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rbassaly264632@samhealth.direct-ci.com
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130722000489 OR Practitioner - Physician Assistant 0143461814 Reassigns benefits to 5 organizations
I20190326002583 WA Practitioner - Physician Assistant 0143461814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians
Mid-Valley Healthcare IncGroup PAC ID 2769391523, shared by 9 NPIs, 143 clinicians

Practice addresses (Care Compare)

10221 SE Sunnyside Rd
Clackamas, OR 97015-9782
Phone (864) 664-3984

11956 SW Garden PL
Tigard, OR 97223-8248
Phone (503) 684-8252

325 Park St
Lebanon, OR 97355-4229
Phone (541) 451-7200

400 N Santiam Hwy
Lebanon, OR 97355
Phone (541) 451-6388

7451 SW Bridgeport Rd
Tigard, OR 97224-7207
Phone (864) 664-3984

Hospital & facility affiliations

  • First Call Home Health Agency, LLC Home health agency, Salem, OR, CCN 387147
  • Signature Healthcare at Home Home health agency, Eugene, OR, CCN 387140
  • Samaritan Lebanon Community Hospital Hospital, Lebanon, OR, CCN 381323
  • Samaritan Albany General Hospital Hospital, Albany, OR, CCN 380022

Merit-based Incentive Payment System (MIPS)

Final score
96.77 of 100Reported as group
Quality
88.09
Promoting interoperability
100
Improvement activities
40
Cost
84.48

National Provider Directory

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

Practice roles (10 of 12)

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 9, 2020 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Jun 19, 2023 Accepting new patients
Icco, LLC CurrentSince Oct 12, 2020 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Jun 19, 2023 Accepting new patients
Beaverton Rehab & Specialty Care, LLC CurrentSince Sep 15, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 9, 2020 Accepting new patients
Mid-Valley Healthcare, Inc. PastSince Jun 1, 2023 Accepting new patients
Uptown Providers PC Past Accepting new patients
Zoomcare PC Past Accepting new patients
Uptown Providers PC Past Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

9800 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2457

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

675 N 5th St
Ste 200
Lebanon, OR 97355
Phone (541) 451-6282

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

9427 SW Barnes Rd
Ste 296
Portland, OR 97225
Phone (503) 297-3778

3060 SE Hawthorne Blvd
Portland, OR 97214

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1362268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1043551930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PARK ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554229",
            "telephone_number": "541-451-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9800 SE Sunnyside Rd",
            "address_purpose": "LOCATION",
            "city": "Clackamas",
            "state": "OR",
            "postal_code": "970159750",
            "country_code": "US",
            "telephone_number": "503-813-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "675 N 5th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973552875",
            "country_code": "US",
            "telephone_number": "541-451-6282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASSALY",
        "first_name": "REDA",
        "middle_name": "TAWFIK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-03",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA163414",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA163414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2035614",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500657182",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbassaly264632@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "325 PARK ST",
            "city": "Lebanon",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973554229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "11245 Huron St",
            "city": "Westminster",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802342806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

Verify at the official NPI Registry.