Individual provider Active NPI

Jennifer I Fluke, PA-C

  • Surgical Physician Assistant
  • Portland, OR
National Provider Identifier
1427347178
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA169660 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-7820
Fax
(503) 494-7829
NPI assigned
Apr 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA06970 TX
Surgical Physician Assistant 363AS0400X 158406 MT
Surgical Physician Assistant 363AS0400X PA169660 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-7820

Other practice location 1

3640 NW Samaritan Dr Ste 120
Corvallis, OR 97330-3738
Phone (541) 768-5223

Other practice location 2

350 Heritage Way Ste 2100
Kalispell, MT 59901-3167
Phone (406) 257-8992

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jfluke205837@samhealth.direct-ci.com
Direct Messaging Address krmcmedicalrecords@krhdirect.org Direct Kalispell Regional Medical Center Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, WA, GA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20180404002173 MT Practitioner - Physician Assistant 9133390594 Reassigns benefits to 1 organization
I20200221002507 WA Practitioner - Physician Assistant 9133390594 Reassigns benefits to 1 organization
I20201113000795 GA Practitioner - Physician Assistant 9133390594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 9537073960, 292 clinicians

Practice addresses (Care Compare)

2901 Sqaulicum Pkwy
Bellingham, WA 98225-1851
Phone (360) 788-9373

2950 Squalicum Pkwy
Suite B
Bellingham, WA 98225-1857
Phone (360) 788-6063

3015 Squalicum Pkwy
Bellingham, WA 98225-1906

310 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 751-6725

320 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 756-3526

350 Heritage Way
Kalispell, MT 59901-3167

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8913GAMDDentist
158406MTMDSurgical Physician Assistant
PA169660ORMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Jan 27, 2020 Accepting new patients
Kalispell Regional Medical Center, Inc CurrentSince Jun 19, 2025 Accepting new patients
Kalispell Regional Medical Center, Inc CurrentSince Jun 19, 2025 Accepting new patients
Peacehealth CurrentSince Jan 27, 2020 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Nov 1, 2020 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Nov 1, 2020 Accepting new patients
Kalispell Regional Medical Center, Inc Past Accepting new patients
Good Samaritan Hospital Corvallis PastSince Aug 4, 2024 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

75 Claremont St
Ste H
Kalispell, MT 59901
Phone (406) 752-7406

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

2979 Squalicum Pkwy
Ste 201
Bellingham, WA 98225
Phone (360) 756-6800

3015 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 715-4186

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org
  • Direct secure messaging: jfluke605104@direct.peacehealth.org
  • Direct secure messaging: jfluke304689@samhealth.direct-ci.com

Organizations & group practices 10

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 3

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": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1427347178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7820",
            "fax_number": "503-494-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7820",
            "fax_number": "503-494-7829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3640 NW Samaritan Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303738",
            "country_code": "US",
            "telephone_number": "541-768-5223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Heritage Way Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013167",
            "country_code": "US",
            "telephone_number": "406-257-8992",
            "fax_number": "406-257-8996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLUKE",
        "first_name": "JENNIFER",
        "middle_name": "I",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA06970",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MT",
            "license": "158406",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA169660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfluke205837@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3640 NW Samaritan Dr Ste 120",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303738",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "350 Heritage Way Ste 2100",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.