Individual provider Active NPI

Mandy L James, PA-C

  • Physician Assistant
  • Beaverton, OR
National Provider Identifier
1285934406
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA161600 Issued in OR
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, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
500699482MedicaidOR

Other names 1

  • Mandy L Blumer Former name

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
I20160706001419 OR Practitioner - Physician Assistant 3375835739 Reassigns benefits to 2 organizations

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

LicenseStateTypeSpecialty
PA161600ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince May 3, 2016 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 1, 2023 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 1, 2023 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.

Hospital & facility affiliations 2

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

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

Verify at the official NPI Registry.