Erica Bernadette Fazzini, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA196871 Issued in OR

Practice address

11782 SW Barnes Rd Ste 300
Portland, OR 97225-5933

Phone

(503) 906-4302

Fax

(503) 906-6613

NPI assigned

Dec 2, 2019

Last updated

May 23, 2022By the provider in NPPES

Sex

Female

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

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic and Fracture Clinic PCGroup PAC ID 1052219953, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

Merit-based Incentive Payment System (MIPS)

Final score

54.33 of 100Reported as group

Quality

57.12

Promoting interoperability

0

Improvement activities

30

Cost

86.48

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: efazzini1189085@oc.providencedirect.org

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.

• Orthopedic & Fracture Clinic PC

  dba Orthopedic and Fracture Specialists

  • Orthopaedic Surgery Physician
  • Portland, OR
  • NPI 1285683656

  Surgical

  Medicare reassignment Care Compare group NPD

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

• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1740827377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 E BARNETT RD STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11782 SW BARNES RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255933",
            "telephone_number": "503-906-4302",
            "fax_number": "503-906-6613"
        }
    ],
    "practiceLocations": [
        {
            "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": "FAZZINI",
        "first_name": "ERICA",
        "middle_name": "BERNADETTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "196871",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA196871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE NUMBER",
            "identifier": "PA196871",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Fay, R.T. (R)
• Shannon Fay, PA-C
• Katharine Elizabeth Fazal, LMFT
• Hannah Fazendin, LMT
• Sergio Fazio, MD, PHD
• FDS Alliance Residential LLC
• Samantha Larae Feagins
• Forrest Wayne Fearington, MD
• James Douglas Fearl, JAMES FEARL
• Fearless With Food, LLC

• Surgical Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Surgical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.

Verify at the official NPI Registry.