Individual provider Active NPI

Kimberlee Ann Fielder, PA-C

  • Physician Assistant
  • Beaverton, OR
National Provider Identifier
1396020186
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA160106 Issued in OR
Practice address
6800 SW 105TH Ave Ste 206
Beaverton, OR 97008-5487
Phone
(503) 430-1777
Fax
(503) 430-1777
NPI assigned
Oct 12, 2011
Last updated
Jan 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 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 PA160106 OR Primary

Addresses

Primary practice location

6800 SW 105TH Ave Ste 206
Beaverton, OR 97008-5487

Mailing address

6800 SW 105TH Ave Ste 206
Beaverton, OR 97008-5487
Phone (503) 430-1777

Other practice location 1

450 N Graham St
Portland, OR 97227-1682
Phone (503) 413-4488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, NE2 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

Enrollment IDStateProvider typePAC IDDetails
I20130913000147 OR Practitioner - Physician Assistant 0042463028 Reassigns benefits to 5 organizations
I20260520000243 NE Practitioner - Physician Assistant 0042463028 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
Group practices
Regional West Physicians ClinicGroup PAC ID 2062301609, 136 clinicians
CRM Physicians LLCGroup PAC ID 3678720729, 59 clinicians

Practice addresses (Care Compare)

2 W 42ND St
Scottsbluff, NE 69361-4669
Phone (308) 635-1717

650 SE Oak St
Hillsboro, OR 97123-4120
Phone (503) 648-8588

6800 SW 105TH Ave
Beaverton, OR 97008-5487

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Slocum Orthopedics, PC CurrentSince Jul 1, 2013 Accepting new patients
Icco LLC CurrentSince Feb 1, 2014 Accepting new patients
Slocum Orthopedics, PC Surgical CurrentSince Jul 1, 2013 Accepting new patients
Legacy Clinics LLC CurrentSince Jan 1, 2026 Accepting new patients
Arizona Heart Specialists PLLC Past Accepting new patients

Locations

55 Coburg Rd
Eugene, OR 97401
Phone (541) 485-8111

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2222 NW Lovejoy St
Ste 411
Portland, OR 97210
Phone (503) 413-5702

450 N Graham St
Portland, OR 97227
Phone (503) 413-4161

Organizations & group practices 9

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 1

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": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1396020186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SW 105TH AVE STE 206",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085487",
            "telephone_number": "503-430-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 SW 105TH AVE STE 206",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085487",
            "telephone_number": "503-430-1777",
            "fax_number": "503-430-1777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 N Graham St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271682",
            "country_code": "US",
            "telephone_number": "503-413-4488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIELDER",
        "first_name": "KIMBERLEE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA160106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.