Individual provider Active NPI

Megan Huang, PA

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1417223629
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA180927 Issued in OR
Practice address
10803 SE Cherry Blossom Dr
Portland, OR 97216-3107
Phone
(503) 261-7200
NPI assigned
Apr 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1020398 GA
Physician Assistant 363A00000X PA180927 OR Primary

Addresses

Primary practice location

10803 SE Cherry Blossom Dr
Portland, OR 97216-3107

Mailing address

10803 SE Cherry Blossom Dr
Portland, OR 97216-3107
Phone (503) 261-7200

Other identifiers 3

IdentifierTypeStateIssuer
LD003593OtherGAGEORGIA BOARD OF EXAMINERS OF LICENSED DIETITIANS
01020398OtherGACOMMISSION ON DIETETIC REGISTRATION
500719911MedicaidOR

Other names 1

  • Megan Jeffords Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170127002663 OR Practitioner - Physician Assistant 8820370745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10803 SE Cherry Blossom Dr
Portland, OR 97216-3107

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1020398GAMDRegistered Dietitian
PA180927ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valeria Health, LLC Dietitian, Registered PastSince Dec 1, 2019 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1417223629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10803 SE CHERRY BLOSSOM DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163107",
            "telephone_number": "503-261-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10803 SE CHERRY BLOSSOM DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163107",
            "telephone_number": "503-261-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "MEGAN",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "1020398",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA180927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA BOARD OF EXAMINERS OF LICENSED DIETITIANS",
            "identifier": "LD003593",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "01020398",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500719911",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "JEFFORDS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.