Kathryn Peak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA194744 Issued in OR

Practice address

2275 W Burnside St Ste B
Portland, OR 97210-3541

Phone

(503) 575-7112

NPI assigned

Jan 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Know Allergy, LLC 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Know Allergy LLC

  • Allergy Physician
  • Portland, OR
  • NPI 1265034987

  OR

  Medicare reassignment Care Compare group
• Allergy Asthma & Dermatology Associates PC

  • Dermatology Physician
  • Portland, OR
  • NPI 1801849849
  NPD (past)

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1821360348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 W BURNSIDE ST STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103541",
            "telephone_number": "503-575-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 W BURNSIDE ST STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103541",
            "telephone_number": "503-575-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAK",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-30",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA194744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ausa Peacock, LMT
• Brandy Peacock, LMT
• Heather Peacock
• Lisa Peacock, LMFT
• Mark Robert Peacock, PTA
• Gerald Peake, PMHNP
• Meredith L. Peake, M.D.
• Michelle Renee Peake
• Peaks to Plains Counseling, LLC
• Christopher David Pearce, O.D.

• All providers in Portland, OR
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.