Active NPI
Machya Spelletich-Pecoraro
- Acute Care Nurse Practitioner
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 202107394NP-PP
- Practice address
- 3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011 - Phone
- (503) 494-4314
- Fax
- (503) 346-6810
- NPI assigned
- Nov 22, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 201392174RN | OR | |
| Family Nurse Practitioner | 363LF0000X | 201710045NP-PP | OR | |
| Acute Care Nurse Practitioner | 363LA2100X | 202107394NP-PP | OR | Primary |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Mailing address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-4314
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311
Hospital & facility affiliations
- Ohsu Hospital and Clinics
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.11 of 100
- Quality
- 84.29
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201392174RN | OR | MD | Registered Nurse |
| 202107394NP-PP | OR | MD | Acute Care Nurse Practitioner |
| 201710045NP-PP | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oregon Health & Science University | Current | Accepting new patients | |
| Tuality Medical Group LLC | Current | Accepting new patients | |
| Oregon Health & Science University | Current | Accepting new patients | |
| Tuality Medical Group LLC | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Registered Nurse | Current | Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
3930 SE Division St
Portland, OR 97202
Phone (503) 418-3900
51377 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 418-4222
Interoperability endpoints
- mspelletichpecoraro86091@direct.ohsu.edu
Organizations & group practices 6
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.
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
- Rural Health Clinic/Center
- Scappoose, OR
- NPI 1417969304
-
- Internal Medicine Physician
- Hillsboro, OR
- NPI 1073929782
-
- Community/Retail Pharmacy
- Portland, OR
- NPI 1457129678
-
- Neurology Physician
- Hillsboro, OR
- NPI 1639690704
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641859200000",
"number": "1740794072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-4314",
"fax_number": "503-346-6810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-4314",
"fax_number": "503-346-6810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPELLETICH-PECORARO",
"first_name": "MACHYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-22",
"last_updated": "2022-01-11",
"certification_date": "2022-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "201392174RN",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "201710045NP-PP",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "OR",
"license": "202107394NP-PP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.