Individual provider Active NPI

Amber Ihander, PA-C

  • Medical Physician Assistant
  • Grants Pass, OR
National Provider Identifier
1558778985
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA168930 Issued in OR
Practice address
1701 NW Hawthorne Ave
Grants Pass, OR 97526-1257
Phone
(541) 472-4777
NPI assigned
Jul 17, 2014
Last updated
Jul 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA168930 OR Primary

Addresses

Primary practice location

1701 NW Hawthorne Ave
Grants Pass, OR 97526-1257

Mailing address

1701 NW Hawthorne Ave
Grants Pass, OR 97526-1257

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
I20140918002708 OR Practitioner - Physician Assistant 0547489858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1701 NW Hawthorne Ave
Grants Pass, OR 97526-1051
Phone (541) 472-4777

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA168930ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Siskiyou Community Health Center, Inc CurrentSince Sep 2, 2014 Accepting new patients
Siskiyou Community Health Center Inc Past Accepting new patients

Locations

1701 NW Hawthorne Ave
Grants Pass, OR 97526
Phone (541) 471-3455

1701 NW Hawthorne Ave
#201
Grants Pass, OR 97526

1701 NW Hawthorne Ave
Ste 201
Grants Pass, OR 97526
Phone (541) 471-3455

830 NE 9th St
Grants Pass, OR 97526
Phone (541) 471-3455

Interoperability endpoints

  • Direct secure messaging: amber.ihander@direct.siskiyou.nextgenshare.com

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 2

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": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1558778985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 NW HAWTHORNE AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 NW HAWTHORNE AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261257",
            "telephone_number": "541-472-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHANDER",
        "first_name": "AMBER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA168930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.