Pamela J Phelan, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA203665 Issued in OR

Practice address

6958 SW Varns Street
Southwest Diagnostic Imaging, LTD
Portland, OR 97223-2530

Phone

(503) 683-7730

Fax

(039) 140-9275

NPI assigned

Mar 22, 2006

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 names 1

• Pamela J Crossen Former name

Medicare fee-for-service enrollment

Enrolled in AZ, OR2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vascular and Interventional Partners PLLCGroup PAC ID 9739587775, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Vascular and Interventional Partners PLLC

  • Vascular & Interventional Radiology Physician
  • Scottsdale, AZ
  • NPI 1457021438
  Medicare reassignment Care Compare group
• PNW Management Group

  • Vascular & Interventional Radiology Physician
  • Portland, OR
  • NPI 1588283154
  Medicare reassignment
• Interventional Services Group PLLC

  • Vascular & Interventional Radiology Physician
  • Phoenix, AZ
  • NPI 1093667933
  Medicare reassignment
• Associated Valley Radiologists LTD

  • Diagnostic Radiology Physician
  • Glendale, AZ
  • NPI 1932683257
  NPD (past)
• Banner Imaging Services LLC

  • Diagnostic Radiology Physician
  • Sun City, AZ
  • NPI 1770139958
  NPD (past)
• Scottsdale Medical Imaging, LTD

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1407823610
  NPD (past)

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

• Banner - University Medical Center Phoenix

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1841224870
  Care Compare affiliation

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1649239278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6958 SW VARNS STREET",
            "address_2": "SOUTHWEST DIAGNOSTIC IMAGING, LTD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972232530",
            "telephone_number": "503-683-7730",
            "fax_number": "039-140-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6958 SW VARNS STREET",
            "address_2": "SOUTHWEST DIAGNOSTIC IMAGING, LTD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972232530",
            "telephone_number": "503-683-7730",
            "fax_number": "039-140-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "PAMELA",
        "middle_name": "J",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "3302",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA203665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "CROSSEN",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pharmacy Acquisition Co., LLC
• Pharmacy Dot Com 82ND
• Matthew Pharris
• Erin Ella Phelan, LMT
• Linda Ann Phelan, RD,CSR,LD
• Erika Susan Phelps Nishiguchi, MD
• Alicia Aileen Phelps, LCSW
• Andrew Phelps
• Carolyn M Phelps, MD
• Jasmine Phelps, LMT

• Surgical Physician Assistant in Portland, OR
• Providers in Portland, 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 Jan 26, 2022; 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.