Individual provider Active NPI

Erik Stephen Gillis, PA-C MHS

  • Physician Assistant
  • Salem, OR
National Provider Identifier
1346723038
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA189473 Issued in OR
Practice address
1233 Edgewater St NW
Salem, OR 97304-4049
Phone
(503) 378-7526
NPI assigned
Sep 10, 2018
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 PA189473 OR Primary

Addresses

Primary practice location

1233 Edgewater St NW
Salem, OR 97304-4049

Mailing address

1233 Edgewater St NW
Salem, OR 97304-4049
Phone (503) 378-7526

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address erik.gillis.p1@direct.nwhumanservices.nextgenshare.com Direct Northwest Human Services, Inc.

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
I20190118002714 OR Practitioner - Physician Assistant 9638416225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Human Services IncGroup PAC ID 7012825797, 33 clinicians

Practice addresses (Care Compare)

1233 Edgewater St NW
Salem, OR 97304-4049
Phone (503) 378-7526

681 Ctr St NE
Salem, OR 97301-3722

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA189473ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Human Services, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Northwest Human Services, Inc. CurrentSince Oct 1, 2018 Accepting new patients

Locations

180 Atwater St N
Monmouth, OR 97361
Phone (503) 378-7526

1233 Edgewater St NW
Salem, OR 97304
Phone (503) 378-7526

Interoperability endpoints

  • Direct secure messaging: erik.gillis.p1@direct.nwhumanservices.nextgenshare.com

Organizations & group practices 2

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": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1346723038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 EDGEWATER ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044049",
            "telephone_number": "503-378-7526",
            "fax_number": "503-588-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 EDGEWATER ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044049",
            "telephone_number": "503-378-7526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "ERIK",
        "middle_name": "STEPHEN",
        "credential": "PA-C MHS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-10",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA189473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "erik.gillis.p1@direct.nwhumanservices.nextgenshare.com",
            "affiliation": "Y",
            "affiliationName": "Northwest Human Services, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1233 Edgewater St NW",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973044049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.