Individual provider Active NPI

David Scot Belli, PA-C

  • Physician Assistant
  • Hillsboro, OR
National Provider Identifier
1083793509
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00690 Issued in OR
Practice address
18610 NW Cornell Rd Ste 101
Hillsboro, OR 97124-9206
Phone
(503) 216-9360
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00690 OR
Physician Assistant 363A00000X PA00690 OR Primary

Addresses

Primary practice location

18610 NW Cornell Rd Ste 101
Hillsboro, OR 97124-9206

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other identifiers 1

IdentifierTypeStateIssuer
500603468MedicaidOR

Other names 1

  • Scot Belli Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://proofpointisolation.com/browser?url=https%3A%2F%2Fcareepicwest.kp.org%3A14430%2Finterconnect-prodnwm%2Fwcf%2Fepic.community.hie%2Fxcpdrespondinggatewaysync.svc%2Fceq 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: 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
I20080102000473 OR Practitioner - Physician Assistant 2668552704 Reassigns benefits to 1 organization
I20211220000688 WA Practitioner - Physician Assistant 2668552704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

3500 N Interstate Ave
Portland, OR 97227-1196
Phone (800) 813-2000

3550 N Interstate Ave
Portland, OR 97227-1196
Phone (800) 813-2000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 9, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 9, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 25, 2021 Accepting new patients

Locations

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

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

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1083793509",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18610 NW CORNELL RD STE 101",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971249206",
            "telephone_number": "503-216-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLI",
        "first_name": "DAVID",
        "middle_name": "SCOT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA00690",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500603468",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://proofpointisolation.com/browser?url=https%3A%2F%2Fcareepicwest.kp.org%3A14430%2Finterconnect-prodnwm%2Fwcf%2Fepic.community.hie%2Fxcpdrespondinggatewaysync.svc%2Fceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "18610 NW Cornell Rd Ste 101",
            "city": "Hillsboro",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971249206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SCOT",
            "last_name": "BELLI",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.