Ivy Nicole Tueller, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA218318 Issued in OR

Practice address

620 NW 11TH St Ste M206
Hermiston, OR 97838-6941

Phone

(541) 667-3804

Fax

(541) 667-0192

NPI assigned

Sep 11, 2018

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

Medicare fee-for-service enrollment

Enrolled in NY, OR2 enrollments

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 2

Specialty

Physician Assistant

Education

Mercy College, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Good Shepherd Health Care SystemGroup PAC ID 9133033764, 125 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Shepherd Medical Center Hospital, Hermiston, OR, CCN 381325

Merit-based Incentive Payment System (MIPS)

Final score

77.82 of 100Reported as group

Quality

64.68

Promoting interoperability

100

Improvement activities

40

Cost

47.05

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: itueller1501840@direct.lhs.org

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.

• Good Shepherd Health Care System

  • Critical Access Hospital
  • Hermiston, OR
  • NPI 1295789667
  Medicare reassignment Care Compare group NPD
• The Westchester Medical Practice, PC

  • Specialist
  • Yorktown Heights, NY
  • NPI 1225222953
  Medicare reassignment NPD
• Mskcc Surgery Group

  • Surgical Oncology Physician
  • New York, NY
  • NPI 1699766261
  Medicare reassignment
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment
• Good Shepherd Health Care System

  • Pediatrics Physician
  • Hermiston, OR
  • NPI 1336198159
  NPD

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

• Good Shepherd Health Care System

  • Critical Access Hospital
  • Hermiston, OR
  • NPI 1295789667
  Care Compare affiliation

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1790268209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 NW 11TH ST STE M206",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978386941",
            "telephone_number": "541-667-3804",
            "fax_number": "541-667-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 NW 11TH ST STE M206",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978386941",
            "telephone_number": "541-667-3804",
            "fax_number": "541-667-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUELLER",
        "first_name": "IVY",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "022776",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA218318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• True North Psychiatric Solutions
• Gary J Trupp, MD
• Mark Truskowski, DPT
• Alexis Xiaowei Tuck, MD
• Kristin Rae Tuckwiller, PHARMD
• Nu Nwe Tun, MD
• David Turnbull
• Floyd Arnold Turnbull, DC
• Bradley Tymchuk, M.D.
• Stephanie Uggen

• Surgical Physician Assistant in Hermiston, OR
• Providers in Hermiston, 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 Jun 9, 2026; 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.