Joshua Constantino Micallef, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA223289 Issued in OR

Practice address

4805 NE Glisan St Ste 6N40
Portland, OR 97213-2933

Phone

(844) 987-0491

NPI assigned

Jun 19, 2021

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

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.

• Providence Health & Services Oregon

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group
• Providence Health & Services - Oregon

  • Family Medicine Physician
  • Gresham, OR
  • NPI 1053419218
  NPD
• Providence Health & Services Oregon

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• Providence Health & Services - Oregon

  • Internal Medicine Physician
  • Sherwood, OR
  • NPI 1184729329
  NPD (past)

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

{
    "created_epoch": "1624060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1457920985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST STE 6N40",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "844-987-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICALLEF",
        "first_name": "JOSHUA",
        "middle_name": "CONSTANTINO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-19",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA223289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mia Neuse, L.Ac., LLC
• Heather Marie Miadowicz, MSPT
• Elizabeth A Miakinkoff, LMT, LMP, CA
• Burhan Ahmed Mian, MD
• Cassandra Miasnikov
• Ivana Micanovic
• Sydney Keen Micek, BA
• Michael Baskin MD LLC
• Michael C Royse, DMD, LLC
• Michael D Moneta MD PC

• 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 Mar 13, 2025; 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.