Individual provider Active NPI

Jared Miracle, PA-C

  • Physician Assistant
  • Beaverton, OR
National Provider Identifier
1205726569
Registry record updated May 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6800 SW 105TH Ave
Beaverton, OR 97008-5468
Phone
(503) 430-1777
NPI assigned
Jul 8, 2025
Last updated
May 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2026

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 Primary

Addresses

Primary practice location

6800 SW 105TH Ave
Beaverton, OR 97008-5468

Mailing address

6800 SW 105TH Ave
Beaverton, OR 97008-5468
Phone (503) 430-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250813003282 OR Practitioner - Physician Assistant 1254839673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRM Physicians LLCGroup PAC ID 3678720729, 59 clinicians

Practice addresses (Care Compare)

6800 SW 105TH Ave
Beaverton, OR 97008-5468
Phone (503) 430-1777

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CRM Physicians, LLC Physician Assistant CurrentSince Mar 1, 2026 Accepting new patients
United Wound Healing Accountable Care Consultants PLLC Physician Assistant PastSince Jul 13, 2025 Accepting new patients

Locations

6800 SW 105th Ave
Beaverton, OR 97008

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.

NPI Registry JSON

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777766400000",
    "number": "1205726569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SW 105TH AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085468",
            "telephone_number": "503-430-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 SW 105TH AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085468",
            "telephone_number": "503-430-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRACLE",
        "first_name": "JARED",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-08",
        "last_updated": "2026-05-03",
        "certification_date": "2026-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.