Brandy Shay Pestka

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5555 N Channel Ave
BLD. 72
Portland, OR 97217-7655

Phone

(503) 228-0295

NPI assigned

May 23, 2012

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

Enrolled in OR, WA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216

  OR

  Medicare reassignment NPD
• Northwest Acute Care Specialists PC

  • Emergency Medicine Physician
  • Portland, OR
  • NPI 1215983200

  OR, WA

  Medicare reassignment
• Providence Health & Services Oregon

  • Critical Access Hospital
  • Seaside, OR
  • NPI 1578500492

  OR

  Medicare reassignment
• Legacy Good Samaritan Hospital and Medical Center

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1609896174
  NPD
• Providence Health & Services - Oregon

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1003223959
  NPD
• Providence Health & Services - Oregon

  • Family Medicine Physician
  • Hillsboro, OR
  • NPI 1003916354
  NPD
• Providence Health & Services - Oregon

  • Family Medicine Physician
  • Gresham, OR
  • NPI 1053419218
  NPD
• Providence Health & Services - Oregon

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1124458914
  NPD
• Providence Health & Services Oregon

  • Rural Health Clinic/Center
  • Seaside, OR
  • NPI 1649344458
  NPD
• Providence Health & Services Oregon

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• Providence Health & Services Oregon

  • Rural Health Clinic/Center
  • Warrenton, OR
  • NPI 1972039170
  NPD
• Northwest Acute Care Specialists PC

  • Emergency Medicine Physician
  • Vancouver, WA
  • NPI 1487811048
  NPD

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1174883102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 N CHANNEL AVE",
            "address_2": "BLD. 72",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177655",
            "telephone_number": "503-228-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 N CHANNEL AVE",
            "address_2": "BLD. 72",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177655",
            "telephone_number": "503-228-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESTKA",
        "first_name": "BRANDY",
        "middle_name": "SHAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Pervisky, RN
• Vera Pervitsky, PHARMD, BCOP, BCPS
• Sephanie Rachel Pesa, AU.D.
• Radu Pescarus, MD
• Laura Pestana, DO
• Travis Scott Petchell, QMHA-R, PWS
• Aura Petcu, NP
• Julia Peteet
• Bradley James Petek, MD
• Peter H Addy LLC

• All providers in Portland, OR
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.