NPIMap

Individual provider Active NPI

Justin Rocha, PA-C

  • Medical Physician Assistant
  • Hillsboro, OR
National Provider Identifier
1649942517
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA207937 Issued in OR
Practice address
4660 NE Belknap CT Ste 119
Hillsboro, OR 97124-8402
Phone
(503) 359-4773
NPI assigned
Sep 29, 2021
Last updated
Sep 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA207937 OR Primary

Addresses

Primary practice location

4660 NE Belknap CT Ste 119
Hillsboro, OR 97124-8402

Mailing address

1909 Mountain View LN Ste 200
Forest Grove, OR 97116-2894
Phone (503) 359-4773

Other practice location 1

1909 Mountain View Ln Ste 200
Forest Grove, OR 97116-2894
Phone (503) 359-4773

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
I20211223000024 OR Practitioner - Physician Assistant 1658762844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Timothy J Gray DO LLCGroup PAC ID 1355390584, 11 clinicians

Practice addresses (Care Compare)

1909 Mountain View LN
Suite 200
Forest Grove, OR 97116-2894
Phone (503) 359-4773

4660 NE Belknap CT
Suite 119
Hillsboro, OR 97124-8402
Phone (503) 359-4773

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA207937ORMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: justin.rocha.1@26386.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1649942517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 MOUNTAIN VIEW LN STE 200",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162894",
            "telephone_number": "503-359-4773",
            "fax_number": "503-359-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 NE BELKNAP CT STE 119",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971248402",
            "telephone_number": "503-359-4773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1909 Mountain View Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Forest Grove",
            "state": "OR",
            "postal_code": "971162894",
            "country_code": "US",
            "telephone_number": "503-359-4773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCHA",
        "first_name": "JUSTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA207937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.