Individual provider Active NPI

Arthur Jeffery Nelson, PA-C

  • Physician Assistant
  • Lake Oswego, OR
National Provider Identifier
1831716646
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA201757 Issued in OR
Practice address
17550 Provost St Ste 201
Lake Oswego, OR 97034-5199
Phone
(503) 872-2440
Fax
(503) 513-3355
NPI assigned
Jun 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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 PA201757 OR Primary

Addresses

Primary practice location

17550 Provost St Ste 201
Lake Oswego, OR 97034-5199

Mailing address

17550 Provost St Ste 201
Lake Oswego, OR 97034-5199
Phone (503) 872-2440

Other practice location 1

2280 Marcola Rd
Springfield, OR 97477-2594
Phone (541) 747-4300

Other practice location 2

1255 NE Grant St Unit C
Hillsboro, OR 97124-3479
Phone (503) 927-7393

Other practice location 3

1800 Centennial Blvd
Springfield, OR 97477-4379
Phone (541) 747-4300

Other practice location 4

2850 SE Powell Valley Rd Ste 100
Gresham, OR 97080-1495
Phone (503) 666-5050

Other identifiers 1

IdentifierTypeStateIssuer
500787098MedicaidOR

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
I20210202001796 OR Practitioner - Physician Assistant 5890109821 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

Hospital & facility affiliations

  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Nov 1, 2022 Accepting new patients
Urgent Care NW Gresham PC CurrentSince Nov 1, 2020 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients
Nerve and Pain Institute LLC Past Accepting new patients

Locations

2850 SE Powell Valley Rd
Ste 100
Gresham, OR 97080
Phone (503) 666-5050

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

Organizations & group practices 5

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1831716646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17550 PROVOST ST STE 201",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970345199",
            "telephone_number": "503-872-2440",
            "fax_number": "503-513-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17550 PROVOST ST STE 201",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970345199",
            "telephone_number": "503-872-2440",
            "fax_number": "503-513-3355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2280 Marcola Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974772594",
            "country_code": "US",
            "telephone_number": "541-747-4300",
            "fax_number": "541-747-0655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1255 NE Grant St Unit C",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971243479",
            "country_code": "US",
            "telephone_number": "503-927-7393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Centennial Blvd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974774379",
            "country_code": "US",
            "telephone_number": "541-747-4300",
            "fax_number": "541-747-0655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2850 SE Powell Valley Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970801495",
            "country_code": "US",
            "telephone_number": "503-666-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ARTHUR",
        "middle_name": "JEFFERY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-26",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA201757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500787098",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.