Kristin Kathleen Mauer, PA C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA150681 Issued in OR

Practice address

19250 SW 65TH Ave
Suite 235
Tualatin, OR 97062-7452

Phone

(503) 692-4820

Fax

(503) 612-0793

NPI assigned

Oct 11, 2007

Last updated

Aug 15, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Richard B. Rosenfield MD PCGroup PAC ID 0446208763, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kristin.mauer.1@22607.direct.athenahealth.com

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.

• Richard B. Rosenfield MD PC

  dba Pearl Women's Center

  • Medical Specialty Clinic/Center
  • Portland, OR
  • NPI 1639360902
  Medicare reassignment Care Compare group
• TS Billings, LLC

  • Trauma Surgery Physician
  • Portland, OR
  • NPI 1497776488
  Medicare reassignment
• Pearl Surgicenter, LLC

  • Ambulatory Surgical Clinic/Center
  • Portland, OR
  • NPI 1407997125
  NPD
• North General Physician Services PLLC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1851315337
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1568650828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322684",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19250 SW 65TH AVE",
            "address_2": "SUITE 235",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627452",
            "telephone_number": "503-692-4820",
            "fax_number": "503-612-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUER",
        "first_name": "KRISTIN",
        "middle_name": "KATHLEEN",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "011967",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA150681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500602008",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne Elizabeth Martin, MA. CCC-SLP
• Rachel Martinez, IBCLC, RLC
• Yusuf Tumuti Mathai, MD
• Rick A. Matthias, DMD
• Krista Mattson, D.D.S
• Jude Taylor Mauge
• Patrick G McBee, M.D.
• Susan McCall, MD
• Carmen McCallum, M.D.
• Karen Anne McClish, MSN, FNP

• Surgical Physician Assistant in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Surgical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.

Verify at the official NPI Registry.