Individual provider Active NPI

Christine Elizabeth Boyer, PA-C

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1124420641
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA196289 Issued in OR
Practice address
4141 N Williams Ave Ste 9a
Portland, OR 97217-2988
Phone
(888) 663-6331
NPI assigned
Sep 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57817 CA
Physician Assistant 363A00000X PA196289 OR Primary

Addresses

Primary practice location

4141 N Williams Ave Ste 9a
Portland, OR 97217-2988

Mailing address

1122 NW Everett St
Portland, OR 97209-2915
Phone (503) 342-2520

Other practice location 1

1122 NW Everett St
Portland, OR 97209-2915
Phone (503) 342-2520

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
I20200921002818 OR Practitioner - Physician Assistant 7113245978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

1122 NW Everett St
Portland, OR 97209-2915
Phone (888) 663-6331

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc CurrentSince Nov 1, 2024 Accepting new patients
One Medical Group, Inc. Past Accepting new patients

Locations

20 N Skidmore St
Portland, OR 97217

1122 NW Everett St
Portland, OR 97209
Phone (503) 342-2520

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.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1124420641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 NW EVERETT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092915",
            "telephone_number": "503-342-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 N WILLIAMS AVE STE 9A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172988",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1122 NW Everett St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972092915",
            "country_code": "US",
            "telephone_number": "503-342-2520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYER",
        "first_name": "CHRISTINE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57817",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA196289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.