Individual provider Active NPI

Aubrey Mullins

  • Physician Assistant
  • Madras, OR
National Provider Identifier
1336860758
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA220112 Issued in OR
Practice address
500 NE a St Ste 100
Madras, OR 97741-1842
Phone
(541) 383-3005
Fax
(541) 383-1883
NPI assigned
Sep 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA220112 OR Primary

Addresses

Primary practice location

500 NE a St Ste 100
Madras, OR 97741-1842

Mailing address

PO Box 4228
Portland, OR 97208-4228
Phone (541) 383-3005

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
I20240927003044 OR Practitioner - Physician Assistant 5092246280 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Oregon Health Sciences University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multnomah CountyGroup PAC ID 6608771787, 111 clinicians
Mosaic Community HealthGroup PAC ID 5395653497, 78 clinicians

Practice addresses (Care Compare)

12710 SE Division
Mid County Health Center
Portland, OR 97236-3134
Phone (503) 988-3601

500 NE a St
Suite 100
Madras, OR 97741-1842
Phone (541) 383-3005

Hospital & facility affiliations

  • St Charles Madras Hospital, Madras, OR, CCN 381324
  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA220112ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County CurrentSince Sep 1, 2024 Accepting new patients
Mosaic Community Health CurrentSince Jan 20, 2026 Accepting new patients
Multnomah County CurrentSince Sep 1, 2024 Accepting new patients
Mosaic Community Health PastSince Jan 20, 2026 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-3674

12710 SE Division St
Portland, OR 97236
Phone (503) 988-3410

375 NW Beaver St
Ste 101
Prineville, OR 97754
Phone (541) 316-6026

Organizations & group practices 5

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 3

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": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1336860758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4228",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084228",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NE A ST STE 100",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977411842",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "AUBREY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA220112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madras, OR

Sources for this page

Verify at the official NPI Registry.