NPIMap

Individual provider Active NPI

Michelle M Edwards, PA-C

  • Physician Assistant
  • Hood River, OR
National Provider Identifier
1598949844
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01298 Issued in OR
Practice address
1108 June St
Hood River, OR 97031-1513
Phone
(541) 387-6125
Fax
(541) 387-6321
NPI assigned
Dec 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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 PA01298 OR Primary

Addresses

Primary practice location

1108 June St
Hood River, OR 97031-1513

Mailing address

PO Box 3390
Portland, OR 97208-3390

Other identifiers 2

IdentifierTypeStateIssuer
2718104MedicaidOR
500608081MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medwards131322@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090821000245 OR Practitioner - Physician Assistant 0446304661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Oregon Health Sciences University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services OregonGroup PAC ID 7315856010, shared by 5 NPIs, 80 clinicians

Practice addresses (Care Compare)

1108 June St
Hood River, OR 97031-1513
Phone (541) 387-6125

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95 of 100Reported as group
Quality
83.34
Promoting interoperability
100
Improvement activities
40
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01298ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Jul 31, 2012 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 31, 2012 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 31, 2012 Accepting new patients

Locations

1108 June St
Hood River, OR 97031
Phone (541) 386-5070

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Interoperability endpoints

  • Direct secure messaging: medwards131322@oc.providencedirect.org

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 4

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": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1598949844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3390",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 JUNE ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311513",
            "telephone_number": "541-387-6125",
            "fax_number": "541-387-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2718104",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500608081",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medwards131322@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1108 June St",
            "city": "Hood River",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970311513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hood River, OR

Sources for this page

Verify at the official NPI Registry.