Active NPI
Amelia Sarah Evans, M.D.
- Family Medicine Physician
- Portland, OR
National Provider Identifier
1508092180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD152661
- Practice address
- 3036 NE MLK Jr Blvd
Portland, OR 97212-3053 - Phone
- (503) 889-2500
- NPI assigned
- Jun 9, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A107979 | CA | |
| Family Medicine Physician | 207Q00000X | MD152661 | OR | Primary |
Addresses
Primary practice location
3036 NE MLK Jr Blvd
Portland, OR 97212-3053
Mailing address
PO Box 8459
Portland, OR 97207-8459
Other practice location 1
800 N Main St
Santa Ana, CA 92701-3576
Phone (714) 456-7002
Other names 1
- Amelia Sarah Edelman
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | aevans471280@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Oregon Health Sciences University School of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 NW 12TH Ave
Suite 107
Battle Ground, WA 98604-9141
Phone (360) 723-0528
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A107979 | CA | MD | Family Medicine Physician |
| MD152661 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cascadia Health | Current | Accepting new patients | |
| Cascadia Health | Current | Accepting new patients | |
| Providence Health & Services - Washington | Past | Accepting new patients | |
| Vital Care, PLLC | Family Medicine | Past | Accepting new patients |
Locations
707 NW Everett St
Portland, OR 97209
Phone (503) 222-4906
3036 NE Mlk Jr Blvd
Portland, OR 97212
Phone (503) 283-3763
Interoperability endpoints
- amelia.evans.1@27390.direct.athenahealth.com
- aevans342728@direct.ochin.org
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Portland, OR
- NPI 1336196401
-
- Primary Care Clinic/Center
- Portland, OR
- NPI 1144722935
-
- Substance Use Disorder Rehabilitation Hospital Unit
- Hoquiam, WA
- NPI 1043374119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620259200000",
"number": "1508092180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8459",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972078459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3036 NE MLK JR BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972123053",
"telephone_number": "503-889-2500"
}
],
"practiceLocations": [
{
"address_1": "800 N Main St",
"address_purpose": "LOCATION",
"city": "Santa Ana",
"state": "CA",
"postal_code": "927013576",
"country_code": "US",
"telephone_number": "714-456-7002",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EVANS",
"first_name": "AMELIA",
"middle_name": "SARAH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-09",
"last_updated": "2021-05-06",
"certification_date": "2021-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A107979",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD152661",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "aevans471280@oc.providencedirect.org",
"affiliation": "N",
"address_1": "4816 NW Bethany Blvd",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972299254",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "AMELIA",
"last_name": "EDELMAN",
"middle_name": "SARAH",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.