Active NPI
Mandy L James, PA-C
- Physician Assistant
- Beaverton, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA161600
- Practice address
- 12345 SW Horizon Blvd Ste 57
Beaverton, OR 97007-9475 - Phone
- (503) 216-8820
- NPI assigned
- Oct 22, 2010
- Last updated
- Apr 22, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA61243759 | WA | |
| Physician Assistant | 363A00000X | PA161600 | OR | Primary |
Addresses
Primary practice location
12345 SW Horizon Blvd Ste 57
Beaverton, OR 97007-9475
Mailing address
PO Box 3158
Portland, OR 97208-3158
Other practice location 1
4340 N Interstate Ave
Portland, OR 97217-3211
Phone (503) 215-1444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500699482 | Medicaid | OR |
Other names 1
- Mandy L Blumer
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12345 SW Horizon Blvd
Suite 57
Beaverton, OR 97007-9475
Phone (503) 216-8820
1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250
2400 E Douglas Ave
BLDG K
Newberg, OR 97132-1461
Phone (971) 231-5855
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA161600 | OR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients |
Locations
12345 SW Horizon Blvd
Ste 57
Beaverton, OR 97007
Phone (503) 216-8820
200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500
440 NW Division St
Gresham, OR 97030
Phone (503) 215-9500
5555 NE Elam Young Pkwy
Hillsboro, OR 97124
Phone (503) 216-1600
2400 E Douglas Ave
Bldg K
Newberg, OR 97132
Phone (971) 231-5855
9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621
725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000
Organizations & group practices 8
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.
-
dba Providence Medical Group
- General Practice Physician
- Lake Oswego, OR
- NPI 1023488343
-
dba Providence Seaside Hospital
- Critical Access Hospital
- Seaside, OR
- NPI 1578500492
-
dba Providence Medical Group
- Internal Medicine Physician
- Hillsboro, OR
- NPI 1003223959
-
dba Providence Medical Group
- Family Medicine Physician
- Hillsboro, OR
- NPI 1003916354
-
dba Providence Medical Group
- Family Medicine Physician
- Gresham, OR
- NPI 1053419218
-
dba Providence Medical Group
- Internal Medicine Physician
- Hillsboro, OR
- NPI 1124458914
-
dba Providence Seaside Hospital
- Clinical Pathology Physician
- Seaside, OR
- NPI 1093266769
-
dba Providence Seaside Hospital - Providence Warrenton Clinic
- Rural Health Clinic/Center
- Warrenton, OR
- NPI 1972039170
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence Portland Medical Center
- General Acute Care Hospital
- Portland, OR
- NPI 1003991845
-
- Case Manager/Care Coordinator
- Portland, OR
- NPI 1891822995
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745280000000",
"number": "1285934406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12345 SW HORIZON BLVD STE 57",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970079475",
"telephone_number": "503-216-8820"
}
],
"practiceLocations": [
{
"address_1": "4340 N Interstate Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972173211",
"country_code": "US",
"telephone_number": "503-215-1444",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JAMES",
"first_name": "MANDY",
"middle_name": "L",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-22",
"last_updated": "2025-04-22",
"certification_date": "2025-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA61243759",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA161600",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500699482",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MANDY",
"last_name": "BLUMER",
"middle_name": "L",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.