NPIMap

Individual provider Active NPI

Andrea Leigh Huxtable, PAC

  • Surgical Physician Assistant
  • Portland, OR
National Provider Identifier
1205463312
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA202788 Issued in OR
Practice address
2701 NW Vaughn St Ste 150
Portland, OR 97210-5379
Phone
(503) 229-8455
Fax
(503) 229-7028
NPI assigned
Mar 26, 2020
Last updated
Jan 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA202788 OR Primary

Addresses

Primary practice location

2701 NW Vaughn St Ste 150
Portland, OR 97210-5379

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2177842MedicaidWA
500793275MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_ent_nw_good_sam_front_desk_pool12223127@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
I20210525000754 OR Practitioner - Physician Assistant 2264831270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

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 Jun 28, 2021 Accepting new patients
The Oregon Clinic, PC CurrentSince Jun 28, 2021 Accepting new patients

Locations

2222 NW Lovejoy St
Ste 622
Portland, OR 97210
Phone (503) 229-8455

2701 NW Vaughn St
Ste 150
Portland, OR 97210
Phone (503) 229-8455

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

847 NE 19th Ave
Ste 300
Portland, OR 97232

500 N Highway
Saint Helens, OR 97051
Phone (503) 229-7554

Interoperability endpoints

  • Direct secure messaging: ahuxtable1747138@oc.providencedirect.org
  • Direct secure messaging: cc_otoc_ent_nw_good_sam_front_desk_pool12223127@oc.providencedirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1205463312",
    "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": "2701 NW VAUGHN ST STE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105379",
            "telephone_number": "503-229-8455",
            "fax_number": "503-229-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUXTABLE",
        "first_name": "ANDREA",
        "middle_name": "LEIGH",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA202788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2177842",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500793275",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_ent_nw_good_sam_front_desk_pool12223127@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "2701 NW Vaughn St Ste 150",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972105379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.