Annie Mae Legard, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01328 Issued in OR

Practice address

511 SW 10TH Ave
Suite 1301
Portland, OR 97205-2732

Phone

(503) 228-0155

Fax

(503) 226-8342

NPI assigned

Feb 6, 2008

Last updated

Dec 13, 2019By 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 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

Oregon Health Sciences University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barzin Khalili MD LLCGroup PAC ID 7911095443, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Barzin Khalili, M.D., LLC

  dba Allergy Clinic

  • Allergy & Immunology Physician
  • Portland, OR
  • NPI 1003005711
  Medicare reassignment Care Compare group
• Allergy Clinic LLC

  • Allergy Physician
  • Portland, OR
  • NPI 1679790604
  NPD (past)

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1275711830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE",
            "address_2": "SUITE 1301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052732",
            "telephone_number": "503-228-0155",
            "fax_number": "503-226-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE",
            "address_2": "SUITE 1301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052732",
            "telephone_number": "503-228-0155",
            "fax_number": "503-226-8342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGARD",
        "first_name": "ANNIE",
        "middle_name": "MAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legacy Health
• Legacy Health System
• Legacy Laboratory Services, LLC
• Legacy Outpatient Imaging LLC
• Legacy United Home Care LLC
• Quinn Elspeth Legg
• Veronica Legg, FNP
• Amanda Gordon Leggett, LMT
• Guinevere Leggett
• James Everett Leggett Jr., MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.