Individual provider Active NPI

Amanda Christine Marsiglia, PA-C

  • Surgical Physician Assistant
  • Portland, OR
National Provider Identifier
1649790221
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA181674 Issued in OR
Practice address
2222 NW Lovejoy St Ste 304
Portland, OR 97210-5100
Phone
(503) 413-4992
NPI assigned
Jun 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA181674 OR
Surgical Physician Assistant 363AS0400X PA181674 OR Primary

Addresses

Primary practice location

2222 NW Lovejoy St Ste 304
Portland, OR 97210-5100

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other identifiers 2

IdentifierTypeStateIssuer
2082077MedicaidWA
500727998MedicaidOR

Other names 1

  • Amanda Christine Francis Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_ent_nw_good_sam_front_desk_pool12223127@oc.providencedirect.org The Oregon Clinic PC

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
I20170725001013 OR Practitioner - Physician Assistant 1355611351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Baylor College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

2222 NW Lovejoy St
Portland, OR 97210-5100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA181674ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Mar 5, 2025 Accepting new patients

Locations

25050 SE Stark St
Ste 265
Gresham, OR 97030
Phone (503) 413-2005

2222 NW Lovejoy St
Ste 304
Portland, OR 97210
Phone (503) 274-4994

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2222 NW Lovejoy St
Ste 622
Portland, OR 97210
Phone (503) 229-8455

Organizations & group practices 1

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 2

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": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1649790221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST STE 304",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105100",
            "telephone_number": "503-413-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSIGLIA",
        "first_name": "AMANDA",
        "middle_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA181674",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA181674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2082077",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500727998",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_ent_nw_good_sam_front_desk_pool12223127@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "2222 NW Lovejoy St Ste 622",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972105104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "FRANCIS",
            "middle_name": "CHRISTINE",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.