NPIMap

Individual provider Active NPI

Kristine R Niles

  • Physician Assistant
  • Albany, OR
National Provider Identifier
1184366551
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA222457 Issued in OR
Practice address
1086 7TH Ave SW Ste 101
Albany, OR 97321-1954
Phone
(541) 812-5530
NPI assigned
Apr 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA222457 OR Primary

Addresses

Primary practice location

1086 7TH Ave SW Ste 101
Albany, OR 97321-1954

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

1697 Stucki Dr
Santa Clara, UT 84765-5142
Phone (509) 405-3100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kniles305703@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240919001113 OR Practitioner - Physician Assistant 3779024617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany General HospitalGroup PAC ID 9931097987, 191 clinicians

Practice addresses (Care Compare)

1086 7TH Ave SW
Albany, OR 97321-1997

705 Elm St SW
Suite 200
Albany, OR 97321-1957
Phone (541) 812-4850

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Albany General Hospital CurrentSince Oct 1, 2024 Accepting new patients
Albany General Hospital CurrentSince Oct 1, 2024 Accepting new patients

Locations

1086 7th Ave SW
Ste 101
Albany, OR 97321
Phone (541) 812-3349

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

Organizations & group practices 3

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.

Hospital & facility affiliations 53

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1184366551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 7TH AVE SW STE 101",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211954",
            "telephone_number": "541-812-5530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1697 Stucki Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Clara",
            "state": "UT",
            "postal_code": "847655142",
            "country_code": "US",
            "telephone_number": "509-405-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NILES",
        "first_name": "KRISTINE",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA222457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kniles305703@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1086 7th Ave SW Ste 101",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.