Individual provider Active NPI

Baredu Bonso Wotcha, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Salem, OR
National Provider Identifier
1518540798
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA218535 Issued in OR
Practice address
3099 River Rd S
Salem, OR 97302-9754
Phone
(503) 581-1567
Fax
(503) 581-1567
NPI assigned
May 4, 2021
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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 PA218535 OR Primary

Addresses

Primary practice location

3099 River Rd S
Salem, OR 97302-9754

Mailing address

3099 River Rd S
Salem, OR 97302-9754
Phone (503) 581-1567

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
I20240308003128 OR Practitioner - Physician Assistant 3274979596 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willamette Ear Nose and Throat LLPGroup PAC ID 5597737643, 14 clinicians

Practice addresses (Care Compare)

3099 River Rd S
Salem, OR 97302-9754
Phone (503) 581-1567

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA218535ORMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: bwotcha391742@direct.salemhealth.org
  • Direct secure messaging: wotchab@entsalem.emadirect.md

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1518540798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3099 RIVER RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973029754",
            "telephone_number": "503-581-1567",
            "fax_number": "503-581-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3099 RIVER RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973029754",
            "telephone_number": "503-581-1567",
            "fax_number": "503-581-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOTCHA",
        "first_name": "BAREDU",
        "middle_name": "BONSO",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA218535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.