Carley Putnam, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA187398 Issued in OR

Practice address

3303 SW Bond Ave Ste 5
Portland, OR 97239-4501

Phone

(503) 494-6687

Fax

(503) 494-1717

NPI assigned

Oct 31, 2017

Last updated

Sep 10, 2019By 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

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, 2017

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)

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cputnam119256@direct.ohsu.edu

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.

• University Professional Services

  • General Practice Physician
  • Portland, OR
  • NPI 1376709535
  Medicare reassignment Care Compare group
• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272
  Medicare reassignment
• University Professional Services

  dba OHSU Home Infusion Pharmacy

  • Pharmacy
  • Beaverton, OR
  • NPI 1073054714
  NPD
• University Professional Services

  dba OHSU Avel Gordly Center for Healing

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1316354970
  NPD

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

• Oregon Health & Science University

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1609824010
  Care Compare affiliation

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1649782699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 NW NAITO PKWY STE 185",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092535",
            "telephone_number": "503-525-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 SW BOND AVE STE 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-6687",
            "fax_number": "503-494-1717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2850 SE Powell Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "97080",
            "country_code": "US",
            "telephone_number": "503-666-5050",
            "fax_number": "503-666-1162",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2850 SE Powell Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "97080",
            "country_code": "US",
            "telephone_number": "503-666-5050",
            "fax_number": "503-666-1162",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2850 SE Powell Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "97080",
            "country_code": "US",
            "telephone_number": "503-666-5050",
            "fax_number": "503-666-1162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUTNAM",
        "first_name": "CARLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA187398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James S Puterbaugh, M.D.
• Rex Puterbaugh, M.D.
• Ronne Puterbaugh
• Rebecca Putna
• Bryan James Putnam, DO
• James S Putnam, MD
• Katherine Elizabeth Putnam, MD, MPH
• Mandy Mae Putnam, CADC II
• Philip Putnam
• Jennifer Putrzenski

• 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 Sep 10, 2019; 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.