Individual provider Active NPI

Maria Abigail Larios Velasquez, PA-C

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1437030996
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2250 NW Flanders St Ste 109
Portland, OR 97210-5409
Phone
(503) 468-7485
NPI assigned
Sep 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

2250 NW Flanders St Ste 109
Portland, OR 97210-5409

Mailing address

2250 NW Flanders St Ste 109
Portland, OR 97210-5409
Phone (503) 468-7485

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
I20251123000149 OR Order and Referring Only - Physician Assistant 0042702409

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Medical Solutions LLC CurrentSince Sep 14, 2025 Accepting new patients

Locations

2250 NW Flanders St
Ste 109
Portland, OR 97210
Phone (503) 228-6294

Interoperability endpoints

  • Direct secure messaging: maria.larios.velasquez.1@30065.direct.athenahealth.com

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": "1757462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1437030996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 NW FLANDERS ST STE 109",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105409",
            "telephone_number": "503-468-7485",
            "fax_number": "503-567-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 NW FLANDERS ST STE 109",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105409",
            "telephone_number": "503-468-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARIOS VELASQUEZ",
        "first_name": "MARIA",
        "middle_name": "ABIGAIL",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "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.