NPIMap

Individual provider Active NPI

John M Nightingale, PA-C

  • Physician Assistant
  • Lincoln City, OR
National Provider Identifier
1215212840
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA156053 Issued in OR
Practice address
825 NW Highway 101 Ste a
Lincoln City, OR 97367-3241
Phone
(541) 994-7480
Fax
(541) 557-6439
NPI assigned
Oct 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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 PA156053 OR Primary

Addresses

Primary practice location

825 NW Highway 101 Ste a
Lincoln City, OR 97367-3241

Mailing address

PO Box 1194
Corvallis, OR 97339-1194

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jnightingale5483@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
I20120119000771 OR Practitioner - Physician Assistant 4284685595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan North Lincoln HospitalGroup PAC ID 7911816301, 42 clinicians

Practice addresses (Care Compare)

3043 NE 28TH St
Lincoln City, OR 97367-4518
Phone (541) 994-3661

825 NW Hwy 101
Lincoln City, OR 97367-3241
Phone (541) 996-7840

Hospital & facility affiliations

  • Samaritan North Lincoln Hospital Hospital, Lincoln City, OR, CCN 381302

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.23
Promoting interoperability
100
Improvement activities
40
Cost
100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Pacific Health Services, Inc CurrentSince Nov 8, 2020 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Nov 15, 2011 Accepting new patients
Samaritan Pacific Health Services Inc CurrentSince Nov 8, 2020 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Nov 15, 2011 Accepting new patients
Samaritan North Lincoln Hospital Past Accepting new patients

Locations

777 NW 9th St
Ste 102
Corvallis, OR 97330
Phone (541) 768-6769

825 NW Highway 101
Ste A
Lincoln City, OR 97367
Phone (541) 996-7480

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

Interoperability endpoints

  • Direct secure messaging: jnightingale5483@samhealth.direct-ci.com

Organizations & group practices 7

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 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": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1215212840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1194",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NW HIGHWAY 101 STE A",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973673241",
            "telephone_number": "541-994-7480",
            "fax_number": "541-557-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIGHTINGALE",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-14",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA156053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jnightingale5483@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "825 NW Highway 101 Ste A",
            "city": "Lincoln City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973673241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lincoln City, OR

Sources for this page

Verify at the official NPI Registry.