Stephanie Warye, MPAS, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA153224 Issued in OR

Practice address

2228 NW Pettygrove St Ste 150
Portland, OR 97210-2761

Phone

(032) 885-2015

Fax

(503) 288-0151

NPI assigned

Sep 13, 2010

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 1

Other names 1

• Stephanie Benjamin Former 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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Modern Nose Clinic LLCGroup PAC ID 5597036897, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephanie.warye.1@20484.direct.athenahealth.com

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.

• Modern Nose Clinic LLC

  • Otolaryngology Physician
  • Salem, OR
  • NPI 1851825566

  WA

  Medicare reassignment Care Compare group NPD
• Modern Nose Clinic LLC

  • Otolaryngology Physician
  • Salem, OR
  • NPI 1043874696
  NPD (past)
• Orthopedic & Sports Medicine Center of Or LLC

  • Orthopaedic Surgery Physician
  • Scappoose, OR
  • NPI 1639596588
  NPD (past)

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693612800000",
    "number": "1265749188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 NW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092953",
            "telephone_number": "503-684-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228 NW PETTYGROVE ST STE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102761",
            "telephone_number": "032-885-2015",
            "fax_number": "503-288-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARYE",
        "first_name": "STEPHANIE",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2023-09-02",
        "certification_date": "2023-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA153224",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054088",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA153224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500647021",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "BENJAMIN",
            "credential": "MPAS PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Warrior Service Company LLC
• Warriors Clinic LLC
• Eric F Warshaw, M.D.
• Leigh Warsing, PAC
• Melissa B. Warstadt, MD
• Hailey Ann Warzel
• Daniel Wasgatt
• Andrew Wash, PHARMD
• Diana Marcela Wash, RN
• Alexis Lee Washam

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.