Jessica Gilbertson Hitchcock, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD23993 Issued in OR

Practice address

4805 NE Glisan St
E3
Portland, OR 97213-2933

Phone

(503) 284-8841

Fax

(503) 282-3302

NPI assigned

Jul 21, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 17, 2017 through Nov 17, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jessica.hitchcock.1@28621.direct.athenahealth.com

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.

• Eugene Therapy LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Eugene, OR
  • NPI 1295065530
  NPD (past)
• Mind Matters PC

  • Psychologist
  • Beaverton, OR
  • NPI 1285839019
  NPD (past)

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504224000000",
    "number": "1477552305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3439 NE SANDY BLVD, PMB 375",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "503-284-8841",
            "fax_number": "503-282-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "address_2": "E3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-284-8841",
            "fax_number": "503-282-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITCHCOCK",
        "first_name": "JESSICA",
        "middle_name": "GILBERTSON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2017-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OR",
            "license": "MD23993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286343",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Winona Hiserote
• Mohammad Hissourou III, MD
• Darcy Elizabeth Hitchcock, LAC
• Devin Hitchcock, DC
• Emily E Hitchcock, MD
• Howard Hiton, MS, LPC
• Chloe Hitt
• Hive Mind Medicine Inc
• Hive Mind Medicine, Inc
• Karen A Hixson, LPC

• Child & Adolescent Psychiatry Physician in Portland, OR
• Providers in Portland, OR by specialty
• Child & Adolescent Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.