Individual provider Active NPI

Shelley Dunlop, PA-C

  • Physician Assistant
  • Vancouver, WA
National Provider Identifier
1194905554
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61542773 Issued in WA
Practice address
200 NE Mother Joseph PL Ste 110
Vancouver, WA 98664-3293
Phone
(360) 254-6161
NPI assigned
Nov 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA61542773 WA
Physician Assistant 363A00000X PA61542773 WA Primary

Addresses

Primary practice location

200 NE Mother Joseph PL Ste 110
Vancouver, WA 98664-3293

Mailing address

200 NE Mother Joseph PL Ste 210
Vancouver, WA 98664-3295
Phone (360) 254-6161

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190227000255 OR Practitioner - Physician Assistant 8224377874 Reassigns benefits to 1 organization
I20240628001739 WA Practitioner - Physician Assistant 8224377874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Surgical Specialists PCGroup PAC ID 4183527153, 118 clinicians

Practice addresses (Care Compare)

200 NE Mother Joseph PL
110 Rebound Orthopedics
Vancouver, WA 98664-3293
Phone (360) 254-6161

200 NE Mother Joseph PL
Suite 210
Vancouver, WA 98664-3295

2121 NE 139TH St
300 Rebound
Vancouver, WA 98686-2316
Phone (360) 254-6161

400 NE Mother Joseph PL
Peacehealth Southwest Medical Center
Vancouver, WA 98664-3200
Phone (360) 514-2000

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61542773WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Surgical Specialists, P.C. CurrentSince Jun 1, 2024 Accepting new patients
Northwest Surgical Specialists PC CurrentSince Jun 1, 2024 Accepting new patients
Multnomah County CurrentSince Nov 16, 2018 Accepting new patients
Multnomah County CurrentSince Nov 16, 2018 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-3674

9000 N Lombard St
Portland, OR 97203
Phone (503) 988-5304

200 NE Mother Joseph Pl
Ste 110
Vancouver, WA 98664
Phone (360) 256-8584

200 NE Mother Joseph Pl
Ste 210
Vancouver, WA 98664
Phone (360) 449-1145

2121 NE 139th St
Ste 300
Vancouver, WA 98686

3205 SE 192nd Ave
Ste 105
Vancouver, WA 98683

200 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2990

Interoperability endpoints

  • Direct secure messaging: sdunlop22025@reboundmd.gardenplot.direct-ci.com
  • Direct secure messaging: shelley.dunloppac.p1@direct.reboundmd.nextgenshare.com

Organizations & group practices 5

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 2

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": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1194905554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643295",
            "telephone_number": "360-254-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643293",
            "telephone_number": "360-254-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNLOP",
        "first_name": "SHELLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61542773",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61542773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.