NPIMap

Individual provider Active NPI

Rachel Johnson, PA-C

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1194544916
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA222501 Issued in OR
Practice address
9155 SW Barnes Rd Ste 440
Portland, OR 97225-6631
Phone
(503) 935-8500
Fax
(503) 935-8505
NPI assigned
Oct 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA222501 OR Primary

Addresses

Primary practice location

9155 SW Barnes Rd Ste 440
Portland, OR 97225-6631

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other practice location 1

5050 NE Hoyt St Ste 359
Portland, OR 97213-2983
Phone (503) 935-8501

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_neurosurgery_front_desk_pool12223185@oc.providencedirect.org The Oregon Clinic PC

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
I20241113002034 OR Practitioner - Physician Assistant 6507390564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

4805 NE Glisan
Portland, OR 97213-2933

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

5050 NE Hoyt St
Portland, OR 97213-2983

9155 SW Barnes Rd
Suite 440
Portland, OR 97225-6631
Phone (503) 935-8500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic, PC CurrentSince Nov 25, 2024 Accepting new patients

Locations

5050 NE Hoyt St
Ste 359
Portland, OR 97213
Phone (503) 935-8501

9155 SW Barnes Rd
Ste 440
Portland, OR 97225
Phone (503) 297-3766

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1194544916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD STE 440",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256631",
            "telephone_number": "503-935-8500",
            "fax_number": "503-935-8505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5050 NE Hoyt St Ste 359",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972132983",
            "country_code": "US",
            "telephone_number": "503-935-8501",
            "fax_number": "503-935-8506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RACHEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA222501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_neurosurgery_front_desk_pool12223185@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "5050 NE Hoyt St Ste 359",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.