Individual provider Active NPI

Jason Chen Kee Ling, PA

  • Physician Assistant
  • Woodburn, OR
National Provider Identifier
1790976207
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01394 Issued in OR
Practice address
685 Evergreen Rd
Woodburn, OR 97071-2910
Phone
(503) 362-8385
Fax
(503) 362-8435
NPI assigned
Aug 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01394 OR Primary

Addresses

Primary practice location

685 Evergreen Rd
Woodburn, OR 97071-2910

Mailing address

1793 13TH St SE
Salem, OR 97302-2541
Phone (503) 362-8385

Other practice location 1

1793 13th St SE
Salem, OR 97302-2541
Phone (503) 362-8385

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
I20081209000718 OR Practitioner - Physician Assistant 6406917400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Falls Dermatology LLCGroup PAC ID 5890863492, 100 clinicians

Practice addresses (Care Compare)

1010 SW Coast Hwy
Suite 201
Newport, OR 97365-5240
Phone (541) 257-6393

1390 Waverly Dr SE
Albany, OR 97322-6945
Phone (503) 362-8385

1793 13TH St SE
Salem, OR 97302-2541
Phone (503) 362-8385

685 Evergreen Rd NE
Woodburn, OR 97071-2910
Phone (503) 362-8385

904 SW Bay St
Newport, OR 97365-4860
Phone (866) 599-3376

Merit-based Incentive Payment System (MIPS)

Final score
90.65 of 100Reported as group
Promoting interoperability
89
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01394ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Falls Dermatology, LLC Physician Assistant CurrentSince Oct 6, 2008 Accepting new patients

Locations

1390 Waverly Dr SE
Albany, OR 97322
Phone (541) 967-8385

375 Park Ave
Ste 5
Coos Bay, OR 97420
Phone (541) 267-7543

3132 State St
Ste 110
Medford, OR 97504
Phone (541) 732-1686

904 SW Bay St
Newport, OR 97365
Phone (541) 683-2020

1010 SW Coast Hwy
Ste 201
Newport, OR 97365
Phone (541) 257-6393

9755 SW Barnes Rd
Ste 450
Portland, OR 97225

1793 13th St SE
Salem, OR 97302
Phone 50336283851283

Organizations & group practices 1

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1790976207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1793 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022541",
            "telephone_number": "503-362-8385",
            "fax_number": "503-362-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 EVERGREEN RD",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970712910",
            "telephone_number": "503-362-8385",
            "fax_number": "503-362-8435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1793 13th St SE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973022541",
            "country_code": "US",
            "telephone_number": "503-362-8385",
            "fax_number": "503-362-8435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LING",
        "first_name": "JASON",
        "middle_name": "CHEN KEE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodburn, OR

Sources for this page

Verify at the official NPI Registry.