Shae Noelle Montegna, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00727 Issued in OR

Practice address

650 N Devine Rd Ste B
Vancouver, WA 98661-6979

Phone

(360) 952-4457

Fax

(360) 828-7409

NPI assigned

Nov 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Ms. Shae Noelle Tangredi Professional name

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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rose Medical Groups PCGroup PAC ID 9335430677, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
• Adventist Health Portland Hospital, Portland, OR, CCN 380060

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Rose Medical Groups, PC

  • Family Medicine Physician
  • Battle Ground, WA
  • NPI 1063818573
  Medicare reassignment Care Compare group
• The Vancouver Clinic Inc PS

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment
• Icco, LLC

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment
• The Vancouver Clinic Inc PS

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907
  NPD
• The Vancouver Clinic Inc PS

  • Eyewear Supplier
  • Ridgefield, WA
  • NPI 1760004477
  NPD
• Icco, LLC

  • Family Medicine Physician
  • Veneta, OR
  • NPI 1518990621
  NPD
• Columbia Medical Clinic PC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1184785842
  NPD (past)
• Columbia Pharmacy LLC

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1104121938
  NPD (past)

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

• Legacy Mount Hood Medical Center

  • General Acute Care Hospital
  • Gresham, OR
  • NPI 1255354700
  Care Compare affiliation
• Portland Adventist Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1801887658
  Care Compare affiliation

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1245319169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 NW 20TH AVE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986044175",
            "telephone_number": "360-952-4457",
            "fax_number": "360-828-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N DEVINE RD STE B",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986616979",
            "telephone_number": "360-952-4457",
            "fax_number": "360-828-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEGNA",
        "first_name": "SHAE",
        "middle_name": "NOELLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "OR PA00727",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2003546",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE (PH&S)",
            "identifier": "P01252763",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500606847",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAE",
            "last_name": "TANGREDI",
            "middle_name": "NOELLE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Brandon James Montague
• Brynden Montalto, LABA
• Brizaida Montanez-Ortiz, MS
• Julian S Montanez, APRN, PMHNP-BC
• Katelyn Montanye
• Ossiel Dario Montenegro Jr.
• Rosanne L Monteverdi
• Theresa Lynn Monteverdi
• Dustin P Montgomery, DPT, OCS
• K. Montgomery

• Physician Assistant in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.