Jacob Saldivar

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA223193 Issued in OR

Practice address

5308 N Lombard St
Portland, OR 97203-4218

Phone

(888) 227-3312

Fax

(971) 282-0085

NPI assigned

May 8, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Express Care Or PCGroup PAC ID 1254768732, 60 clinicians

Express Care Wa PCGroup PAC ID 6800128067, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Express Care Or PC

  • General Practice Physician
  • Portland, OR
  • NPI 1205499126
  Medicare reassignment Care Compare group
• Express Care Wa PC

  • General Practice Physician
  • Lacey, WA
  • NPI 1821554452

  OR

  Medicare reassignment Care Compare group
• Rocky Mountain University of Health Professions Foundation

  • Physical Therapist
  • Provo, UT
  • NPI 1053174417
  NPD

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

• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Newberg, OR
  • NPI 1952482275
  Care Compare affiliation

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1457041154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2908",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972082908",
            "telephone_number": "425-207-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5308 N LOMBARD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972034218",
            "telephone_number": "888-227-3312",
            "fax_number": "971-282-0085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6110 SW Sheridan St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972258104",
            "country_code": "US",
            "telephone_number": "971-645-1753",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Novell Pl",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846066101",
            "country_code": "US",
            "telephone_number": "801-375-5125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALDIVAR",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-08",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA223193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Teresa Banez Salcedo, RN, BSN
• Rebecca Christine Salcedo, LMT
• Fernando Salcido Torres
• Zachary Salcido
• Isaac Straube Saldivar
• Katherine Elizabeth Sale
• Victoria Sale, PMHNP-BC
• Aaron Saleen Degrange, DO
• Avantika Saleen, PA-C
• Leena Saleh, PHARMD

• Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.