Kiley Elizabeth Pauck, PA-S

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

705 SE Baseline St
Hillsboro, OR 97123-4244

Phone

(503) 352-6151

NPI assigned

Feb 4, 2025

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: kiley.pauck@897273817595908.direct.elationemr.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.

• Bridgeport Family Medicine LLC

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1205236445
  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": "1738627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1124832787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 SE REEDWAY ST UNIT A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972027527",
            "telephone_number": "541-778-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 SE BASELINE ST",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234244",
            "telephone_number": "503-352-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUCK",
        "first_name": "KILEY",
        "middle_name": "ELIZABETH",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kishoree Jayant Patel, MD
• Minal Patel, PSY.D.
• Rachana Patel
• Burton Charles Pattee, M.D.
• Malcolm Ross Patton, M.A., CADC II, LADC
• Juliet Paul Naone, OTR/L
• Ronald Gerald Pausig, M.D.
• Bharati U Pawar, O.T.
• Emily Ann Payne Rios Umanzor, PT, DPT
• Kayla Payne, LMT

• Student in an Organized Health Care Education/Training Program in Hillsboro, OR
• Providers in Hillsboro, OR by specialty
• Student in an Organized Health Care Education/Training Program in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.