Nicolette Linea Stevanovski, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA220456 Issued in OR

Practice address

500 NE a St Ste 100
Madras, OR 97741-1842

Phone

(541) 383-3005

Fax

(541) 383-1883

NPI assigned

Jan 25, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mosaic Community HealthGroup PAC ID 5395653497, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Charles Home Health Services Home health agency, Bend, OR, CCN 387026
• St Charles Madras Hospital, Madras, OR, CCN 381324
• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nstevanovski720904@direct.ochin.org

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.

• Mosaic Community Health

  dba Mosaic Medical

  • Federally Qualified Health Center (FQHC)
  • Prineville, OR
  • NPI 1083633184
  Medicare reassignment Care Compare group NPD
• Mosaic Community Health

  dba Mosaic Medical

  • Federally Qualified Health Center (FQHC)
  • Madras, OR
  • NPI 1457900011
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cascade Healthcare Community Inc

  dba NW High Desert Sleep Center Bend

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• St. Charles Health System, Inc.

  dba St. Charles Home Health Services

  • Home Health Agency
  • Bend, OR
  • NPI 1144215542
  Care Compare affiliation
• St. Charles Health System, Inc.

  dba St. Charles Home Health

  • Home Health Agency
  • Madras, OR
  • NPI 1225226004
  Care Compare affiliation
• St. Charles Health System, Inc.

  dba St. Charles - Madras

  • Critical Access Hospital
  • Madras, OR
  • NPI 1356389894
  Care Compare affiliation
• St. Charles Health System, Inc.

  dba St. Charles Bend

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1639931629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 MABLE COUCH WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379314284",
            "telephone_number": "248-860-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NE A ST STE 100",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977411842",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2827 Mable Couch Way",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379314284",
            "country_code": "US",
            "telephone_number": "248-860-5913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVANOVSKI",
        "first_name": "NICOLETTE",
        "middle_name": "LINEA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA220456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Charles Health System, Inc. (St. Charles - Madras)
• St. Charles Health System, Inc. (St. Charles Madras - Hospice)
• St. Charles Health System, Inc. (St. Charles Home Health)
• St. Charles Health System, Inc. (St. Charles - Madras)
• Jordan Gunter Stephens, CRM, CADC-R
• Richard Synowski II
• Jessica Brooke Tegen, OD
• Jordy Alexander Tellez
• Shilo Renae Tippett, PH.D.
• Andrew Scott Toms, D.D.S.

• Physician Assistant in Madras, OR
• Providers in Madras, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.