NPIMap

Individual provider Active NPI

Amanda Leigh Barclay, PA-C

  • Physician Assistant
  • Lake Oswego, OR
National Provider Identifier
1053960104
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA195868 Issued in OR
Practice address
17550 Provost St Ste 201
Lake Oswego, OR 97034-5199
Phone
(503) 872-2440
NPI assigned
Sep 10, 2019
Last updated
Feb 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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 PA195868 OR Primary

Addresses

Primary practice location

17550 Provost St Ste 201
Lake Oswego, OR 97034-5199

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abarclay1771907@oc.providencedirect.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191216001529 OR Practitioner - Physician Assistant 0749614246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA195868ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2021 Accepting new patients
Santiam Memorial Hospital CurrentSince Dec 2, 2019 Accepting new patients
Santiam Memorial Hospital CurrentSince Dec 2, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2021 Accepting new patients

Locations

17550 Provost St
Ste 201
Lake Oswego, OR 97034
Phone (503) 513-3350

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

1375 N 10th Ave
Ste B
Stayton, OR 97383
Phone (503) 769-7546

1401 N 10th Ave
Ste 200
Stayton, OR 97383
Phone (503) 769-7151

Interoperability endpoints

  • Direct secure messaging: abarclay1771907@oc.providencedirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1053960104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17550 PROVOST ST STE 201",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970345199",
            "telephone_number": "503-872-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARCLAY",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA195868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abarclay1771907@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "17550 Provost St Ste 201",
            "city": "Lake Oswego",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970345199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.