Gina Marjorie Bawden, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01337 Issued in OR

Practice address

2850 SE Powell Valley Rd
Gresham, OR 97080-1494

Phone

(503) 666-5050

Fax

(503) 666-1162

NPI assigned

Dec 17, 2007

Last updated

May 25, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
• Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

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

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, 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 NPD
• The Oregon Clinic PC

  • Specialist
  • Portland, OR
  • NPI 1265417174
  NPD (past)
• The Oregon Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • Portland, OR
  • NPI 1346105129
  NPD (past)
• Emergency Physicians Medical Group, Inc

  • Emergency Medicine Physician
  • Aiea, HI
  • NPI 1639111339
  NPD (past)
• Legacy Salmon Creek Hospital

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

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

• Legacy Emanuel Hospital & Health Center

  dba Unity Center for Behavioral Health-PES

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003367491
  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  dba Legacy Laboratory Services

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1295756898

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Care Compare affiliation
• 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": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1245414978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "503-413-3900",
            "fax_number": "503-413-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 SE POWELL VALLEY RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801494",
            "telephone_number": "503-666-5050",
            "fax_number": "503-666-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAWDEN",
        "first_name": "GINA",
        "middle_name": "MARJORIE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-17",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22873",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01337",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500604977",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8504961",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Joseph Bartolotti, LSCW
• Sara ER Bates, QMHP
• Leanne Marie Batzko, MSW
• Maria Baumgarden, PT
• Alexander Bautista
• Bonita Baxter
• Wylie Allan Bay, MSW
• Albert Bazurto, LPC
• BD-Gresham, LLC (Brookside Dental-Gresham)
• Nicholas Beach, D.O.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.