NPIMap

Individual provider Active NPI

Kenyon Jay Solecki, MS, PA-C

  • Physician Assistant
  • Hillsboro, OR
National Provider Identifier
1417476029
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA184757 Issued in OR
Practice address
1200 NE 48TH Ave Ste 1100
Hillsboro, OR 97124-5062
Phone
(503) 844-8219
Fax
(503) 844-8234
NPI assigned
Sep 14, 2017
Last updated
Dec 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 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 PA184757 OR Primary

Addresses

Primary practice location

1200 NE 48TH Ave Ste 1100
Hillsboro, OR 97124-5062

Mailing address

PO Box 5187
Portland, OR 97208-5187
Phone (503) 494-8417

Other practice location 1

2120 Exchange St Ste 111
Astoria, OR 97103-3366
Phone (503) 325-0333

Other practice location 2

335 SE 8th Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171106001496 OR Practitioner - Physician Assistant 4284990367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tuality Medical Group LLCGroup PAC ID 7416173414, 289 clinicians

Practice addresses (Care Compare)

1200 NE 48TH Ave
Suite 1100
Hillsboro, OR 97124-5062
Phone (503) 844-8219

335 SE 8TH Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tuality Medical Group LLC CurrentSince Jun 15, 2023 Accepting new patients
Tuality Healthcare Current Accepting new patients

Locations

1200 NE 48th Ave
Ste 1100
Hillsboro, OR 97124
Phone (503) 844-8219

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

Interoperability endpoints

  • Direct secure messaging: ksolecki81744@direct.ohsu.edu

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1417476029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5187",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972085187",
            "telephone_number": "503-494-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NE 48TH AVE STE 1100",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245062",
            "telephone_number": "503-844-8219",
            "fax_number": "503-844-8234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2120 Exchange St Ste 111",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "OR",
            "postal_code": "971033366",
            "country_code": "US",
            "telephone_number": "503-325-0333",
            "fax_number": "503-325-6333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "335 SE 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234246",
            "country_code": "US",
            "telephone_number": "503-681-1050",
            "fax_number": "503-681-1939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLECKI",
        "first_name": "KENYON",
        "middle_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-14",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA184757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.