David Joseph Gahtan, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01015 Issued in OR

Practice address

1919 NW Lovejoy St
Portland, OR 97209-1503

Phone

(509) 415-5600

NPI assigned

Feb 23, 2006

Last updated

Apr 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.62 of 100Reported as apm

Quality

77.21

Promoting interoperability

99.06

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00337

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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  WA

  Medicare reassignment Care Compare group
• Premier Wound Healing

  • Dermatology Physician
  • Bend, OR
  • NPI 1407554819
  Medicare reassignment
• Advanced Wound Care and Healing PC

  • Dermatology Physician
  • Livermore, CA
  • NPI 1053128553

  OR, WA

  Medicare reassignment
• Active Wound Healing

  • Dermatology Physician
  • Graham, WA
  • NPI 1679264485
  NPD (past)
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  NPD (past)

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1215903059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15271 SE THORNTON DR",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972672552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 NW LOVEJOY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091503",
            "telephone_number": "509-415-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 SW Century Dr Ste 405-392",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977023037",
            "country_code": "US",
            "telephone_number": "541-280-6201",
            "fax_number": "877-684-8059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAHTAN",
        "first_name": "DAVID",
        "middle_name": "JOSEPH",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00464824",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500603044",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence Paul Gagnon, DMD
• Lisa Rose Ariana Gagnon
• Molly Gagnon, COTA
• Diane Marie Gahan, RPH
• Randa Gahin, LMFT, LPC
• Brigitta Theresia Gaida
• Mary Katherine Gaido, RN
• Gail F. Ott DC PC (Lovejoy Chiropratic Clinic)
• Gail Hardman-Woung, LCSW, P.C.
• Thomas A. Gail

• Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.