Individual provider Active NPI

Donald Edwin Winder Jr., PA

  • Medical Physician Assistant
  • Salem, OR
National Provider Identifier
1336411636
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA156714 Issued in OR
Practice address
4999 Skyline Rd S
Salem, OR 97306-2878
Phone
(541) 364-4005
Fax
(541) 364-4006
NPI assigned
Feb 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA156714 OR Primary

Addresses

Primary practice location

4999 Skyline Rd S
Salem, OR 97306-2878

Mailing address

PO Box 1517
Pendleton, OR 97801-0410
Phone (541) 278-4332

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
I20120412000634 OR Practitioner - Physician Assistant 1658532932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

4999 Skyline Rd S
Suite 100
Salem, OR 97306-0001
Phone (503) 364-4005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA156714ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Praxis Health, PC Medical CurrentSince Aug 1, 2024 Accepting new patients
Praxis Health, PC CurrentSince Aug 1, 2024 Accepting new patients
Spinal Diagnostics PC PastSince Jul 13, 2017 Accepting new patients

Locations

4999 Skyline Rd S
Ste 100
Salem, OR 97306
Phone (503) 364-4005

4999 Skyline Rd S
Salem, OR 97306
Phone (503) 364-4005

Organizations & group practices 3

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.

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": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1336411636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "541-278-4332",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4999 SKYLINE RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973062878",
            "telephone_number": "541-364-4005",
            "fax_number": "541-364-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDER",
        "first_name": "DONALD",
        "middle_name": "EDWIN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-01",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA156714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.