Nina O'Mailia, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA152466 Issued in OR

Practice address

21900 Willamette Dr Ste 209
West Linn, OR 97068-3284

Phone

(971) 274-0038

Fax

(971) 202-2099

NPI assigned

Feb 21, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Nina Grady Former name

Medicare fee-for-service enrollment

Enrolled in WA, OR2 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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
• Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025

Merit-based Incentive Payment System (MIPS)

Final score

94.62 of 100Reported as apm

Quality

77.21

Promoting interoperability

99.06

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15142/brand/1/csg/1/fhir/r4

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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  WA

  Medicare reassignment Care Compare group NPD
• Orchid Oakridge Clinic, P.C.

  dba Orchid Health - Oakridge Clinic

  • Rural Health Clinic/Center
  • Oakridge, OR
  • NPI 1588088983
  Medicare reassignment NPD (past)
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  WA

  Medicare reassignment
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1871848457
  NPD
• Orchid Oakridge Clinic, PC

  dba Orchid Health Hoodland Clinic

  • Family Medicine Physician
  • Sandy, OR
  • NPI 1417098773
  NPD
• Orchid Oakridge Clinic, PC

  dba Orchid Health - Fern Ridge Clinic

  • Primary Care Clinic/Center
  • Elmira, OR
  • NPI 1881274348
  NPD
• Orthopedic & Sports Medicine Center of Or LLC

  • Orthopaedic Surgery Physician
  • Scappoose, OR
  • NPI 1639596588
  NPD (past)
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  NPD (past)

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

• Legacy Meridian Park Hospital

  • General Acute Care Hospital
  • Tualatin, OR
  • NPI 1184647620
  Care Compare affiliation
• Legacy Mount Hood Medical Center

  • General Acute Care Hospital
  • Gresham, OR
  • NPI 1255354700
  Care Compare affiliation

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1316116684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11507 SE FLAVEL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972665985",
            "telephone_number": "503-915-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21900 WILLAMETTE DR STE 209",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683284",
            "telephone_number": "971-274-0038",
            "fax_number": "971-202-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MAILIA",
        "first_name": "NINA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA152466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8508384",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500604590",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NINA",
            "last_name": "GRADY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Northwest Primary Care Group, PC
• Daniel Eli Novak, PHD, LCSW, LICSW
• Nursewise Delegations, LLC (NurseWise)
• Joy Nussen, LMFT
• Bridget Theresa O'Boyle-Jordan, CPNP
• Eliza Oh, M.D.
• Paul Adam Olenginski, RPH
• Jaimin Olsen-Kacalek
• Kaylene Lauren Olson, P.T.
• Julia Opalnik, DMD

• Physician Assistant in West Linn, OR
• Providers in West Linn, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.