Marc Kristopher Obando, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA209437 Issued in OR

Practice address

2850 SE Powell Valley Rd
Gresham, OR 97080-1494

Phone

(503) 666-5050

NPI assigned

Aug 31, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR, WA2 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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Orthopaedics, LLPGroup PAC ID 4789725607, 18 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.62 of 100Reported as apm

Quality

77.21

Promoting interoperability

99.06

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Summit Orthopaedics, LLP

  • Orthopaedic Surgery Physician
  • Lake Oswego, OR
  • NPI 1427200021

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Integrated Joint Specialists LLC

  • General Practice Physician
  • Tigard, OR
  • NPI 1942502794
  Medicare reassignment NPD
• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  WA

  Medicare reassignment NPD
• Orthopedic & Fracture Clinic PC

  dba Orthopedic and Fracture Specialists

  • Orthopaedic Surgery Physician
  • Portland, OR
  • NPI 1285683656

  Surgical

  Medicare reassignment NPD
• Amer J Mirza, MD PC

  • Orthopaedic Surgery Physician
  • Lake Oswego, OR
  • NPI 1982033494
  NPD (past)
• Go to Ortho LLC

  dba The Injury Clinic

  • Orthopedic Physical Therapist
  • Lake Oswego, OR
  • NPI 1083206155

  Physician Assistant

  NPD (past)
• Edge Rehabilitation & Wellness LLC

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1770852006
  NPD (past)
• Rea Rehabilitation Services Inc

  dba Edge Rehabilitation & Wellness

  • Rehabilitation Clinic/Center
  • Colorado Springs, CO
  • NPI 1386719052
  NPD (past)

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1710354337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "503-413-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 SE POWELL VALLEY RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801494",
            "telephone_number": "503-666-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11782 SW Barnes Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972255933",
            "country_code": "US",
            "telephone_number": "503-214-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14795 SW Murray Scholls Dr Ste 109",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970079230",
            "country_code": "US",
            "telephone_number": "503-906-4301",
            "fax_number": "503-906-6613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBANDO",
        "first_name": "MARC",
        "middle_name": "KRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-31",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA209437",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA209437",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanelle Deann O'Dell, PA-C
• Allison Jane O'Meara, FNP
• Ardis O'Meara
• Karen Jeanne O'Neill, DO
• Oath East Portland Surgical Center, LLC
• Kathleen Virginia Oberman
• Jennifer Obermeyer, LCSW
• Heather Kamisky Odell, DPT
• Vitalis C. Ogbeama Sr.
• Ohana Garden City Operations LLC (Kelly Gardens Residential Care)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.