Individual provider Active NPI

Clarabel Deleon, PA-C

  • Medical Physician Assistant
  • Hood River, OR
National Provider Identifier
1053309286
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00513 Issued in OR
Practice address
1021 June St
Hood River, OR 97031-1516
Phone
(541) 386-3626
NPI assigned
Oct 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00513 OR Primary

Addresses

Primary practice location

1021 June St
Hood River, OR 97031-1516

Mailing address

1021 June St
Hood River, OR 97031-1516
Phone (541) 386-3626

Other identifiers 1

IdentifierTypeStateIssuer
226813MedicaidOR

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
I20100921000928 OR Practitioner - Physician Assistant 9234254715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Family Medicine - LLCGroup PAC ID 2961564703, 8 clinicians

Practice addresses (Care Compare)

1021 June St
Hood River, OR 97031-1516
Phone (541) 386-4220

Hospital & facility affiliations

  • Providence Hood River Memorial Hospital Hospital, Hood River, OR, CCN 381318
  • Skyline Hospital Hospital, White Salmon, WA, CCN 501315
  • Mid-Columbia Medical Center Hospital, The Dalles, OR, CCN 380001

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Pain Management, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1053309286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 JUNE ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311516",
            "telephone_number": "541-386-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 JUNE ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311516",
            "telephone_number": "541-386-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELEON",
        "first_name": "CLARABEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA00513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226813",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hood River, OR

Sources for this page

Verify at the official NPI Registry.