Colleen D Phillips, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA00406 Issued in OR

Practice address

12400 NW Cornell Rd Ste 200
Portland, OR 97229-5689

Phone

(503) 646-0101

Fax

(503) 350-1420

NPI assigned

Dec 1, 2006

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

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, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portland Plastic Surgery Group, LLCGroup PAC ID 3577787514, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Portland Plastic Surgery Group, LLC

  • Plastic Surgery Physician
  • Portland, OR
  • NPI 1437573185
  Medicare reassignment Care Compare group
• The Waldorf Center for Plastic Surgery

  • Health Service Clinic/Center
  • Portland, OR
  • NPI 1689797169
  NPD (past)
• Yale S. Popowich, M.D., P.C.

  • Plastic Surgery Physician
  • Portland, OR
  • NPI 1457638884
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245308618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 NW JUSTUS LN",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972298551",
            "telephone_number": "503-297-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 NW CORNELL RD STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295689",
            "telephone_number": "503-646-0101",
            "fax_number": "503-350-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "COLLEEN",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA00406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camille Phillips
• Carolyn Rae Phillips, LCSW
• Charles Robert Phillips, MD
• Christopher A. Phillips
• Colleen Alyce Phillips, RN
• Darla Kim Phillips, PT, DPT, OCS, ATC
• Grace Phillips
• Holly Nicole Phillips
• Jacinda Lee Phillips
• Jack Austin Phillips

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.