Individual provider Active NPI

Melissa Ann Small, PA-C

  • Physician Assistant
  • Tigard, OR
National Provider Identifier
1730490590
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7421 SW Bridgeport Rd Ste 220
Tigard, OR 97224-7707
Phone
(503) 684-8252
NPI assigned
Jun 27, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

7421 SW Bridgeport Rd Ste 220
Tigard, OR 97224-7707

Mailing address

1211 NE 64TH LN Unit 704
Hillsboro, OR 97124-6887
Phone (912) 675-5469

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
I20240815001761 OR Practitioner - Physician Assistant 7214116086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

10221 SE Sunnyside Rd
Clackamas, OR 97015-9782
Phone (864) 664-3984

11956 SW Garden PL
Tigard, OR 97223-8248
Phone (503) 684-8252

1400 NE Alberta St
Portland, OR 97211-5044
Phone (864) 664-3984

202 NW 13TH Ave
Portland, OR 97209-2953
Phone (864) 664-3984

25600 SW Argyle Ave
Suite B
Wilsonville, OR 97070-4701
Phone (864) 664-3984

2695 SW Cedar Hills Blvd
Suite 180
Beaverton, OR 97005-1415
Phone (864) 664-3984

2711 NE Town Ctr Dr
Hillsboro, OR 97006-8951
Phone (864) 664-3984

3060 SE Hawthorne Blvd
Portland, OR 97214-4121
Phone (864) 664-3984

606 NE Broadway St
Portland, OR 97232-1212
Phone (864) 664-3984

6910 SE Milwaukie Ave
Portland, OR 97202-5717
Phone (864) 664-3984

7451 SW Bridgeport Rd
Tigard, OR 97224-7207
Phone (864) 664-3984

7855 SW Capitol Hwy
Portland, OR 97219-2465
Phone (864) 664-3984

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1536SCMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Zoomcare Urgent Care LLC PastSince Aug 6, 2023 Accepting new patients
Zoomcare PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4
  • Direct secure messaging: melissa.small.1@30646.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1277596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1730490590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 NE 64TH LN UNIT 704",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971246887",
            "telephone_number": "912-675-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7421 SW BRIDGEPORT RD STE 220",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247707",
            "telephone_number": "503-684-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-27",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.