Individual provider Active NPI

Andrew J Jaszewski, PA-C

  • Physician Assistant
  • Forest Grove, OR
National Provider Identifier
1437197852
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1068 Issued in IA
Practice address
3838 Pacific Ave
Forest Grove, OR 97116-2224
Phone
(999) 999-9999
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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 1068 IA Primary

Addresses

Primary practice location

3838 Pacific Ave
Forest Grove, OR 97116-2224

Mailing address

3838 Pacific Ave
Forest Grove, OR 97116-2224

Other identifiers 1

IdentifierTypeStateIssuer
970024010OtherIARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20120529000536 OR Practitioner - Physician Assistant 1658560347 Reassigns benefits to 1 organization
I20201231001874 WA Practitioner - Physician Assistant 1658560347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2400 Lancaster Dr NE
Salem, OR 97305-1221
Phone (800) 813-2000

5940 Ulali Dr NE
Keizer, OR 97303-1500
Phone (800) 813-2000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 21, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 21, 2020 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1437197852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 PACIFIC AVE",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 PACIFIC AVE",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162224",
            "telephone_number": "999-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASZEWSKI",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "1068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970024010",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Grove, OR

Sources for this page

Verify at the official NPI Registry.