Satchel Harry, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA179787 Issued in OR

Practice address

417 SW 117TH Ave FL 2
Portland, OR 97225-5924

Phone

(503) 216-8980

NPI assigned

Sep 21, 2016

Last updated

Nov 1, 2023By 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 2

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Legacy Good Samaritan Hospital and Medical CenterGroup PAC ID 0547179939, 190 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sharry739293@oc.providencedirect.org

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 Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216
  Medicare reassignment Care Compare group
• Pain Care Specialists of Oregon, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Salem, OR
  • NPI 1942675467
  Medicare reassignment
• Legacy Good Samaritan Hospital and Medical Center

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1609896174
  NPD
• Legacy Good Samaritan Hospital and Medical Center

  dba Legacy Good Samaritan Providers

  • Clinic/Center
  • Portland, OR
  • NPI 1679597108
  NPD

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

• Legacy Good Samaritan Hospital and Medical Center

  dba Legacy Good Samaritan Providers

  • Clinic/Center
  • Portland, OR
  • NPI 1679597108

  Hospital

  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216
  Care Compare affiliation

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1235687013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 SW 117TH AVE FL 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255924",
            "telephone_number": "503-216-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 SW 117TH AVE FL 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255924",
            "telephone_number": "503-216-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRY",
        "first_name": "SATCHEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-21",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "179787",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA179787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sharry739293@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "417 SW 117th Ave Fl 2",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972255924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Harry S Krulewitch, MD PC (NW Geriatrics)
• Emily Harry
• Jane Harry
• Lauren A Harry, MD
• Patrick Harry
• Sasha Katharina Harryman
• Robert M Harsany, M.D.
• Darcy Lynne Harshaw
• Ona Harshbarger
• Jasmin Harshman

• 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 Nov 1, 2023; 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.