Individual provider Active NPI

Amanda S Pinzon, PA-C

  • Physician Assistant
  • Newberg, OR
National Provider Identifier
1508267253
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA175243 Issued in OR
Practice address
1003 Providence Dr
Newberg, OR 97132-7521
Phone
(503) 537-5900
NPI assigned
Sep 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA175243 OR Primary

Addresses

Primary practice location

1003 Providence Dr
Newberg, OR 97132-7521

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other identifiers 1

IdentifierTypeStateIssuer
50695123MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apinzon555965@oc.providencedirect.org

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
I20151111000673 OR Practitioner - Physician Assistant 4688984255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
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)

5050 NE Hoyt St
Suite 454
Portland, OR 97213-2984
Phone (503) 215-6405

Hospital & facility affiliations

  • Providence Home Health Home health agency, Portland, OR, CCN 387048
  • Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Dec 7, 2015 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: apinzon555965@oc.providencedirect.org

Organizations & group practices 3

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 3

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": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1508267253",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 PROVIDENCE DR",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971327521",
            "telephone_number": "503-537-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINZON",
        "first_name": "AMANDA",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA175243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50695123",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apinzon555965@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1000 N Providence Dr Ste 210",
            "city": "Newberg",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971327582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

Verify at the official NPI Registry.