NPIMap

Individual provider Active NPI

Joshin Adrald Luiz, PA-C

  • Medical Physician Assistant
  • Portland, OR
National Provider Identifier
1780026583
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA167747 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-8562
Fax
(503) 494-6324
NPI assigned
Jul 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA167747 OR
Medical Physician Assistant 363AM0700X PA167747 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) 494-8562

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
I20140911002141 OR Practitioner - Physician Assistant 0749418887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

1400 SW 5TH Ave
Suite 500
Portland, OR 97201-5537

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Adventist Health Portland Hospital, Portland, OR, CCN 380060
  • Hillsboro Medical Center Hospital, Hillsboro, OR, CCN 380021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23109CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Sep 15, 2014 Accepting new patients
University Professional Services CurrentSince Sep 15, 2014 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

Interoperability endpoints

  • Direct secure messaging: jluiz87418@direct.ohsu.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1780026583",
    "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": "503-494-8562",
            "fax_number": "503-494-6324"
        },
        {
            "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": "503-494-8562",
            "fax_number": "503-494-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUIZ",
        "first_name": "JOSHIN",
        "middle_name": "ADRALD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-22",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA167747",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA167747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.