Active NPI
Jennifer Tobin, PA-C
- Medical Physician Assistant
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA165082
- Practice address
- 3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011 - Phone
- (503) 494-7641
- NPI assigned
- Oct 17, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA10004894 | WA | |
| Surgical Physician Assistant | 363AS0400X | PA165082 | OR | |
| Medical Physician Assistant | 363AM0700X | PA165082 | OR | Primary |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Mailing address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-7641
Other practice location 1
875 Oak St SE
Suite 5020
Salem, OR 97301-3975
Phone (503) 371-4044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500664202 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442
3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311
3930 SE Division St
Portland, OR 97202-1643
Phone (503) 418-3900
4212 SE Division St
Portland, OR 97206-1681
Phone (503) 418-1500
51377 SW Old Portland Rd
Scappoose, OR 97056-4023
Phone (503) 418-4222
Hospital & facility affiliations
- Ohsu Hospital and Clinics
- Adventist Health Portland
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.11 of 100
- Quality
- 84.29
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA165082 | OR | MD | Medical Physician Assistant |
| PA10004894 | WA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uptown Providers PC | Current | Accepting new patients | |
| Uptown Providers PC | Current | Accepting new patients | |
| Uptown Providers PC | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| Oregon Health & Science University | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| Salem Health | Current | Accepting new patients | |
| Salem Health | Current | Accepting new patients | |
| Moses Lake Community Health Center | Past | Accepting new patients |
Locations
14278 SW Allen Blvd
Beaverton, OR 97005
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
3930 SE Division St
Portland, OR 97202
Phone (503) 418-3900
665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634
875 Oak St SE
Ste 5020
Salem, OR 97301
Phone (503) 371-4044
51377 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 418-4222
8060 SW Pfaffle St
Ste 106
Tigard, OR 97223
180 NE 192nd Ave
Ste 505
Vancouver, WA 98684
Interoperability endpoints
- jtobin92960@direct.ohsu.edu
Organizations & group practices 13
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.
-
- Rural Health Clinic/Center
- Scappoose, OR
- NPI 1417969304
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
- Urgent Care Clinic/Center
- Vancouver, WA
- NPI 1255102034
-
- General Acute Care Hospital
- Salem, OR
- NPI 1265431829
-
- Urgent Care Clinic/Center
- Tigard, OR
- NPI 1346903531
-
- Community/Retail Pharmacy
- Portland, OR
- NPI 1457129678
-
- Durable Medical Equipment & Medical Supplies
- Keizer, OR
- NPI 1487434775
-
- Family Medicine Physician
- Woodburn, OR
- NPI 1578112066
-
- Pharmacy
- Beaverton, OR
- NPI 1073054714
-
- Multi-Specialty Clinic/Center
- Portland, OR
- NPI 1073767588
-
- General Practice Physician
- Portland, OR
- NPI 1144598293
-
- Urgent Care Clinic/Center
- Vancouver, WA
- NPI 1912702465
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
-
- General Acute Care Hospital
- Portland, OR
- NPI 1801887658
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608595200000",
"number": "1508947755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-7641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-7641"
}
],
"practiceLocations": [
{
"address_1": "875 Oak St SE",
"address_2": "Suite 5020",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "OR",
"postal_code": "973013975",
"country_code": "US",
"telephone_number": "503-371-4044",
"fax_number": "503-371-4356",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TOBIN",
"first_name": "JENNIFER",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2020-12-22",
"certification_date": "2020-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA10004894",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "OR",
"license": "PA165082",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "OR",
"license": "PA165082",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500664202",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
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 Dec 22, 2020; 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.