Individual provider Active NPI

Amanda St John

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1598129496
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201602229NP-PP Issued in OR
Practice address
3164 NE 35TH PL
Portland, OR 97212-2728
Phone
(208) 249-5516
NPI assigned
Apr 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201602229NP-PP OR Primary

Addresses

Primary practice location

3164 NE 35TH PL
Portland, OR 97212-2728

Mailing address

3164 NE 35TH PL
Portland, OR 97212-2728

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
I20160427000239 OR Practitioner - Nurse Practitioner 8820397888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Oregon Health Sciences University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
201602229NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Health & Science University CurrentSince Oct 21, 2018 Accepting new patients
Oregon Health & Science University CurrentSince Oct 21, 2018 Accepting new patients
University Professional Services CurrentSince May 31, 2016 Accepting new patients
Oregon Health & Science University Current Accepting new patients
University Professional Services CurrentSince May 31, 2016 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: astjohnnp37172@direct.ohsu.edu

Organizations & group practices 7

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.

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": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1598129496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3164 NE 35TH PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3164 NE 35TH PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122728",
            "telephone_number": "208-249-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST JOHN",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201602229NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.