Individual provider Active NPI

Aaron Michael Liere

  • Physician Assistant
  • Gresham, OR
National Provider Identifier
1255352985
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00665 Issued in OR
Practice address
2850 SE Powell Valley Rd
Gresham, OR 97080-1494
Phone
(503) 666-5050
Fax
(503) 666-7410
NPI assigned
Jul 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00665 OR Primary

Addresses

Primary practice location

2850 SE Powell Valley Rd
Gresham, OR 97080-1494

Mailing address

PO Box 647
Gresham, OR 97030-0167
Phone (503) 666-5050

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090304000549 OR Practitioner - Physician Assistant 2860558541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Express PCGroup PAC ID 0446487102, 2 clinicians

Practice addresses (Care Compare)

4160 NE Sandy Blvd
Portland, OR 97212-5336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00665ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mobilmed Past Accepting new patients
Portland Wellness Care Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255352985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 647",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970300167",
            "telephone_number": "503-666-5050",
            "fax_number": "503-666-7410"
        },
        {
            "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": "503-666-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIERE",
        "first_name": "AARON",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.