Individual provider Active NPI

James M Schroeder, P.A.

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1780630202
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA154561 Issued in OR
Practice address
3036 NE MLK Jr Blvd
Portland, OR 97212-3053
Phone
(503) 283-3763
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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 PA-185 ID
Physician Assistant 363A00000X PA154561 OR Primary

Addresses

Primary practice location

3036 NE MLK Jr Blvd
Portland, OR 97212-3053

Mailing address

798 Eastland Dr
Twin Falls, ID 83301-6856
Phone (208) 734-3312

Other practice location 1

388 Martin St
Twin Falls, ID 83301-4544
Phone (208) 734-0451

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
I20190326002125 OR Practitioner - Physician Assistant 1052204302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cascadia HealthGroup PAC ID 7618873761, 53 clinicians

Practice addresses (Care Compare)

4212 SE Division St
Suite 100
Portland, OR 97206-1680
Phone (503) 236-7166

707 NW Everett St
Portland, OR 97209-3517
Phone (503) 222-4906

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-185IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Medical Foundation of Tillamook CurrentSince Jan 8, 2024 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Jan 8, 2024 Accepting new patients
Cascadia Health Past Accepting new patients
Careoregon Community Health, LLC PastSince Jun 16, 2010 Accepting new patients
Northwest Medical Foundation of Tillamook Past Accepting new patients
Family Health Services Corporation PastSince Jul 15, 1989 Accepting new patients

Locations

1000 3rd St
#M
Tillamook, OR 97141
Phone (503) 815-2260

1100 3rd St
Tillamook, OR 97141
Phone (503) 815-2116

1000 3rd St
Tillamook, OR 97141
Phone (503) 251-6129

1005 Cougar St
Vernonia, OR 97064
Phone (503) 429-0622

Interoperability endpoints

  • Direct secure messaging: jschroeder719633@direct.ochin.org

Organizations & group practices 7

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1780630202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 EASTLAND DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016856",
            "telephone_number": "208-734-3312",
            "fax_number": "208-734-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3036 NE MLK JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123053",
            "telephone_number": "503-283-3763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "388 Martin St",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833014544",
            "country_code": "US",
            "telephone_number": "208-734-0451",
            "fax_number": "208-734-0452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-185",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA154561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.