Geneva Ann Eagon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1200 NW Naito Pkwy Suite #310
Portland, OR 97209

Phone

(503) 292-9200

NPI assigned

Sep 16, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Geneva Ann Green Former 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

Group practices

Portland Plastic Surgery Group, LLCGroup PAC ID 3577787514, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Portland Plastic Surgery Group, LLC

  • Plastic Surgery Physician
  • Portland, OR
  • NPI 1437573185
  Medicare reassignment Care Compare group
• Bridgeport Family Medicine LLC

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1205236445
  NPD (past)
• Yale S. Popowich, M.D., P.C.

  • Plastic Surgery Physician
  • Portland, OR
  • NPI 1457638884
  NPD (past)
• Fornance Physician Services, Inc.

  • Family Medicine Physician
  • Norristown, PA
  • NPI 1013997386
  NPD (past)

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1114533072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NW NAITO PKWY SUITE #310",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97209",
            "telephone_number": "503-292-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NW NAITO PKWY SUITE #310",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97209",
            "telephone_number": "503-292-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGON",
        "first_name": "GENEVA",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2024-10-29",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENEVA",
            "last_name": "GREEN",
            "middle_name": "ANN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Dawn Eagan, MSW, MS
• Eagle Healthcare, Inc
• Patrick G Eagle Staff, PWS/QMHP-C
• Rose Eagle, PH.D.
• Tara Lyn Eagle, D.O.
• Adam Jerome Eakin
• Anthony Charles Eames, PAC
• Sruthi Eapen
• Ear Medical Group a PC
• Sudheer Earanky, DO

• 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 29, 2024; 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.