Kyline Nicole Farwell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA201995 Issued in OR

Practice address

5050 NE Hoyt St Ste 626
Portland, OR 97213-2956

Phone

(503) 917-3950

NPI assigned

Mar 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kylie Nicole Farwell Other name

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
• Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kylie.farwell.1@8752.direct.athenahealth.com

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.

• Gustav Fischer, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Portland, OR
  • NPI 1255590964
  Medicare reassignment
• Natalie Squires Mesnier

  • Orthopaedic Foot and Ankle Surgery Physician
  • Portland, OR
  • NPI 1346366523
  Medicare reassignment
• Nancy Yen Shipley, MD

  • Orthopaedic Surgery Physician
  • Portland, OR
  • NPI 1669681573
  Medicare reassignment

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

• Legacy Mount Hood Medical Center

  • General Acute Care Hospital
  • Gresham, OR
  • NPI 1255354700
  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1093340515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 N INTERSTATE AVE APT 441",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972174792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST STE 626",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132956",
            "telephone_number": "503-917-3950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Forest St",
            "address_purpose": "LOCATION",
            "city": "McCall",
            "state": "ID",
            "postal_code": "836385256",
            "country_code": "US",
            "telephone_number": "208-401-8325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARWELL",
        "first_name": "KYLINE",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA201995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLIE",
            "last_name": "FARWELL",
            "middle_name": "NICOLE",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lisa Lynne Farris
• Roy David Farris, MD
• Shannon Nicole Farrouge, M.A, LPC
• Edith Iris Farrow
• Khashayar Farsad, M.D.
• Ryan M Farwell, OT
• Halley Farwood, PSYD
• Farzad Pirayesh, DMD, P.C.
• Clara Cedarblade Fashana, N.D, L.AC
• Nathan Fasold

• Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.