Elysha Katharina Wiest, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA165833 Issued in OR

Practice address

9155 SW Barnes Rd
Suite 440
Portland, OR 97225-6625

Phone

(503) 935-8500

Fax

(503) 935-8505

NPI assigned

Dec 19, 2013

Sex

Female

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 VT

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Vermont Medical Center IncGroup PAC ID 3779491071, 1,208 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003
• Central Vermont Medical Center Hospital, Barre, VT, CCN 470001
• The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewiest84071@direct.uvmhealth.org

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.

• University of Vermont Medical Center Inc

  • Internal Medicine Physician
  • Burlington, VT
  • NPI 1659309615
  Medicare reassignment Care Compare group NPD
• The Oregon Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • Portland, OR
  • NPI 1346105129
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Vermont Medical Center Inc

  • General Acute Care Hospital
  • Berlin, VT
  • NPI 1508845637
  Care Compare affiliation
• Champlain Valley Physicians Hospital Medical Center

  • General Acute Care Hospital
  • Plattsburgh, NY
  • NPI 1033270699
  Care Compare affiliation
• University of Vermont Medical Center Inc

  • General Acute Care Hospital
  • Burlington, VT
  • NPI 1568419976
  Care Compare affiliation

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1225459183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322684",
            "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": "9155 SW BARNES RD",
            "address_2": "SUITE 440",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256625",
            "telephone_number": "503-935-8500",
            "fax_number": "503-935-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEST",
        "first_name": "ELYSHA",
        "middle_name": "KATHARINA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-19",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA165833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225459183",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500666575",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin M Wiesmann, M.D.
• Julie Hassen Wiesner, LCSW
• Hazel Carlos Wiesse-Perez, MSW
• Christy Ann Wiessner, RN
• Ellen Wiessner
• Elzbieta Wietrzynska, RDH, EPDH, BSDH
• Alexandra Julienne Wiggins-Mohan, MD
• Dylan James Wiggins
• Isaac Wiggins
• Kelly A Wiggins, RN,BSN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.