Individual provider Active NPI

Tara Crosswhite, PA-C

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1417815531
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5441 S Macadam Ave Ste R
Portland, OR 97239-3822
Phone
(480) 712-8319
NPI assigned
Jan 15, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 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 Primary

Addresses

Primary practice location

5441 S Macadam Ave Ste R
Portland, OR 97239-3822

Mailing address

5441 S Macadam Ave Ste R
Portland, OR 97239-3822

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
I20260310000685 OR Practitioner - Physician Assistant 0042793937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athena Medical GroupGroup PAC ID 8921358706, 43 clinicians

Practice addresses (Care Compare)

2355 State St
Suite 101
Salem, OR 97301-4541
Phone (480) 712-8319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athena Medical Group CurrentSince Feb 2, 2026 Accepting new patients

Locations

2355 State St
Ste 101
Salem, OR 97301
Phone (503) 383-9039

Organizations & group practices 1

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": "1768435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1417815531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE R",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE R",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393822",
            "telephone_number": "480-712-8319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSWHITE",
        "first_name": "TARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-15",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.