Chethiya Weligodapola, PA-C
Individual provider Active NPI Surgical Physician Assistant · Portland, OR
NPI 1154944296 · NPPES record last updated Nov 10, 2022
Key facts
- NPI
- 1154944296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- PA210795 (OR)
- Practice address
- 3303 S Bond Ave BLDG 1
Portland, OR 97239-4501 - Phone
- (503) 494-1700
- NPI assigned
- May 23, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 10
Hospital & facility affiliations 13
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University Professional Services
Oregon Health and Science University
Practice addresses (Care Compare)
15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311
4212 SE Division St
Suite 150
Portland, OR 97206-1681
Phone (503) 418-1500
51377 SW Old Portland Rd
Scappoose, OR 97056-4023
Phone (503) 418-4222
Hospital & facility affiliations
- Ohsu Hospital and Clinics
- Hillsboro Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.11 of 100
- Quality
- 84.29
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221122002805 | OR | Practitioner - Physician Assistant | 3274901244 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Professional Services | Current |
Accepting new patients | |
| Oregon Health & Science University | Current |
Accepting new patients | |
| University Professional Services | Current |
Accepting new patients | |
| Oregon Health & Science University | Current |
Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
3303 S Bond Ave
Bldg 1
Portland, OR 97239
Phone (503) 418-3700
3930 SE Division St
Portland, OR 97202
Phone (503) 418-3900
51377 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 418-4222
Interoperability endpoints
- cweligodaploa140005@direct.ohsu.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Surgical Physician Assistant | 363AS0400X | PA210795 | OR | Yes |
Addresses
Primary practice location
3303 S Bond Ave BLDG 1
Portland, OR 97239-4501
Mailing address
3303 S Bond Ave BLDG 1
Portland, OR 97239-4501
Phone (971) 285-0370
Other providers in Portland, OR
- Heather Emily Weldon
- Rachel Marie Weldon
- Stephen Bradley Weldon
- Tara Linnea Weldon
- Richard Gordon Weleber
- Ryen Lee Welker McGrath
- Carla Ann Welker
- Kendyl L Welker
- Melissa A Welker
- Well Being Massage, LLC
All providers in Portland, OR · Surgical Physician Assistant in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.