Individual provider Active NPI

Robert L Titchener, PA

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1528260494
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102690 Issued in NC
Practice address
12360 E Burnside St
Portland, OR 97233-1042
Phone
(971) 279-4800
Fax
(971) 279-2051
NPI assigned
Jun 4, 2007
Last updated
Jul 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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 102690 NC Primary

Addresses

Primary practice location

12360 E Burnside St
Portland, OR 97233-1042

Mailing address

211 SE Caruthers St
Portland, OR 97214-4502
Phone (503) 224-1044

Other practice location 1

703 NE Hancock St
Portland, OR 97212-3955
Phone (503) 230-9875

Other practice location 2

1438 SE Division St
Portland, OR 97202-1140
Phone (503) 548-0346

Other practice location 3

17645 NW Saint Helens Rd
Portland, OR 97231-1729
Phone (503) 621-1069

Other identifiers 2

IdentifierTypeStateIssuer
2015186MedicaidWA
500635810MedicaidOR

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
I20040405000038 OR Practitioner - Physician Assistant 8123011509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Native American Rehabilitation Assoc IncGroup PAC ID 2668361585, shared by 7 NPIs, 16 clinicians

Practice addresses (Care Compare)

12360 E Burnside St
Portland, OR 97233-1042
Phone (971) 279-4800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12793ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Native American Rehabilitation Assoc Inc CurrentSince Mar 27, 2017 Accepting new patients
Native American Rehabilitation Assoc Inc CurrentSince Mar 27, 2017 Accepting new patients
Native American Rehabilitation Assoc Inc Past Accepting new patients

Locations

12360 E Burnside St
Portland, OR 97233
Phone (971) 279-4800

1438 SE Division St
Portland, OR 97202
Phone (503) 548-0346

15 N Morris St
Portland, OR 97227
Phone (503) 230-9875

17645 NW Saint Helens Rd
Portland, OR 97231
Phone (503) 621-1069

1776 SW Madison St
Portland, OR 97205
Phone (503) 224-1044

211 SE Caruthers St
Portland, OR 97214
Phone (503) 224-1044

703 NE Hancock St
Portland, OR 97212
Phone (503) 230-9875

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, 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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1528260494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SE CARUTHERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144502",
            "telephone_number": "503-224-1044",
            "fax_number": "971-260-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12360 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331042",
            "telephone_number": "971-279-4800",
            "fax_number": "971-279-2051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 NE Hancock St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972123955",
            "country_code": "US",
            "telephone_number": "503-230-9875",
            "fax_number": "503-331-3441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1438 SE Division St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972021140",
            "country_code": "US",
            "telephone_number": "503-548-0346",
            "fax_number": "503-232-5959",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17645 NW Saint Helens Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972311729",
            "country_code": "US",
            "telephone_number": "503-621-1069",
            "fax_number": "503-621-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TITCHENER",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2015186",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500635810",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.