Individual provider Active NPI

Kolten William Paryzek, PA-C

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1497267199
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA185522 Issued in OR
Practice address
9155 SW Barnes Rd Ste 210
Portland, OR 97225-6629
Phone
(503) 546-3503
Fax
(503) 546-3507
NPI assigned
Nov 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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 PA185522 OR Primary

Addresses

Primary practice location

9155 SW Barnes Rd Ste 210
Portland, OR 97225-6629

Mailing address

9155 SW Barnes Rd
Ste 210
Portland, OR 97225-6629
Phone (503) 546-3503

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
I20171110002582 OR Practitioner - Physician Assistant 0840556650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J Rafe Sales, MD PCGroup PAC ID 1153481049, 3 clinicians

Practice addresses (Care Compare)

1815 SW Marlow Ave
Suite 101
Portland, OR 97225-5186
Phone (503) 546-3503

9155 SW Barnes Rd
Suite 210
Portland, OR 97225-6629

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Columbia Memorial Hospital Hospital, Astoria, OR, CCN 381320
  • Providence Seaside Hospital Hospital, Seaside, OR, CCN 381303

Merit-based Incentive Payment System (MIPS)

Final score
42.2 of 100Reported as group
Quality
0
Improvement activities
40
Cost
40.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA185522ORMDPhysician Assistant

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1497267199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD",
            "address_2": "STE 210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256629",
            "telephone_number": "503-546-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD STE 210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256629",
            "telephone_number": "503-546-3503",
            "fax_number": "503-546-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARYZEK",
        "first_name": "KOLTEN",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-02",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA185522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.