Individual provider Active NPI

Ryan Planck, PA

  • Physician Assistant
  • Newberg, OR
National Provider Identifier
1336456102
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA207983 Issued in OR
Practice address
1840 E Portland Rd
Newberg, OR 97132-1847
Phone
(888) 227-3312
NPI assigned
Sep 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601005853 MI
Physician Assistant 363A00000X PA207983 OR Primary

Addresses

Primary practice location

1840 E Portland Rd
Newberg, OR 97132-1847

Mailing address

PO Box 3229
Portland, OR 97208-3229
Phone (888) 227-3312

Other practice location 1

1890 US Highway 131 Unit 4
Petoskey, MI 49770-8344
Phone (231) 487-2000

Other practice location 2

4340 N Interstate Ave
Portland, OR 97217-3211
Phone (888) 227-3312

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
I20220325000350 OR Practitioner - Physician Assistant 9830321744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10670 NE Cornell Rd
Hillsboro, OR 97124-9221

12442 SW Scholls Ferry Rd
Suite 100
Tigard, OR 97223-0803
Phone (503) 215-9900

1321 NE 99TH Ave
Suite 100
Portland, OR 97220-9437
Phone (503) 215-9900

1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250

16770 SW Edy Rd
Suite 102
Sherwood, OR 97140-9679
Phone (503) 216-9600

200 S Hazel Dell Way
Canby, OR 97013-7829
Phone (203) 263-9500

5050 NE Hoyt St
Suite 454
Portland, OR 97213-2984
Phone (503) 215-6405

7305 SE Circuit Dr
Suite 140
Hillsboro, OR 97129-1961
Phone (971) 501-4905

9290 SE Sunnybrook Blvd
Suite 120
Clackamas, OR 97015-6802
Phone (503) 215-2110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA207983ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Sep 12, 2022 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

1336 NE Orenco Station Pkwy
Hillsboro, OR 97124

1840 E Portland Rd
Newberg, OR 97132
Phone (503) 538-9360

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

1321 NE 99th Ave
Ste 100
Portland, OR 97220
Phone (503) 215-4050

4340 N Interstate Ave
Portland, OR 97217
Phone (503) 215-1444

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

960 N 16th St
Ste 304
Springfield, OR 97477
Phone (541) 744-6172

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1336456102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3229",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083229",
            "telephone_number": "888-227-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 E PORTLAND RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321847",
            "telephone_number": "888-227-3312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1890 US Highway 131 Unit 4",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497708344",
            "country_code": "US",
            "telephone_number": "231-487-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4340 N Interstate Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972173211",
            "country_code": "US",
            "telephone_number": "888-227-3312",
            "fax_number": "503-215-1445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLANCK",
        "first_name": "RYAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601005853",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA207983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

Verify at the official NPI Registry.