Shung L Nip, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA186105 Issued in OR

Practice address

10123 SE Market St
Portland, OR 97216-2532

Phone

(503) 257-2500

NPI assigned

Sep 20, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR, WA2 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

Merit-based Incentive Payment System (MIPS)

Final score

92 of 100Reported as group

Quality

84.7

Promoting interoperability

100

Improvement activities

40

Cost

79.21

Merit-based Incentive Payment System (MIPS)

Final score

96.85 of 100Reported as group

Quality

84.92

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: snip160399@direct.ohsu.edu

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 NPD
• Portland Adventist Medical Center

  • Family Medicine Physician
  • Portland, OR
  • NPI 1750091021
  Medicare reassignment NPD
• Northwest Acute Care Specialists PC

  • Emergency Medicine Physician
  • Portland, OR
  • NPI 1215983200

  WA

  Medicare reassignment
• Tuality Medical Group LLC

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1073929782
  Medicare reassignment
• Tuality Medical Group LLC

  • Neurology Physician
  • Hillsboro, OR
  • NPI 1639690704
  NPD
• Northwest Acute Care Specialists PC

  • Emergency Medicine Physician
  • Vancouver, WA
  • NPI 1487811048
  NPD

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1386927044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SW 5TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10123 SE MARKET ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162532",
            "telephone_number": "503-257-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 SE 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234246",
            "country_code": "US",
            "telephone_number": "503-681-1860",
            "fax_number": "503-681-1606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIP",
        "first_name": "SHUNG",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-20",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4930",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA186105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z157989",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767347",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nimbus Vision Clinic, LLC
• Alfreda Tina Nimely, QMHA-R
• Jim Beam Nimer
• Nine Suns LLC
• Sandy Thao Mai Ninh, PHARMD
• Leah Nirschel
• Miwa Andrina Nishi, LMT
• Natalie Nishi
• Mural J. Nishikawa, MD
• Fumiyo Nishimoto, LCSW

• Medical Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Medical Physician Assistant in Oregon

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