Individual provider Active NPI

Austin Ebner

  • Physician Assistant
  • Medford, OR
National Provider Identifier
1831717156
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA222378 Issued in OR
Practice address
1841 E Barnett Rd
Medford, OR 97504-8249
Phone
(541) 216-7291
Fax
(541) 636-2163
NPI assigned
Jul 13, 2020
Last updated
May 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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 PA61128002 WA
Physician Assistant 363A00000X PA222378 OR Primary

Addresses

Primary practice location

1841 E Barnett Rd
Medford, OR 97504-8249

Mailing address

6351 W Rio Grande Ave
Kennewick, WA 99336-7634
Phone (509) 543-9280

Other practice location 1

6351 W Rio Grande Ave
Kennewick, WA 99336-7634
Phone (509) 543-9280

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aebner35234@yvfwc.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, 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

Enrollment IDStateProvider typePAC IDDetails
I20210816001760 WA Practitioner - Physician Assistant 5193120004 Reassigns benefits to 2 organizations
I20260429002358 OR Practitioner - Physician Assistant 5193120004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care and Medical Centers PSGroup PAC ID 7618865775, 19 clinicians
Icco LLCGroup PAC ID 1355406729, 133 clinicians

Practice addresses (Care Compare)

1215 George Washington Way
Richland, WA 99352-3411
Phone (509) 946-1695

1516 Jadwin Ave
Richland, WA 99354-2902
Phone (509) 946-1695

1841 E Barnett Rd
Medford, OR 97504-8249
Phone (541) 216-7291

3601 Plaza Way
Kennewick, WA 99338-2716
Phone (509) 236-0391

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA222378ORMDPhysician Assistant
PA61128002WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic CurrentSince Jul 9, 2021 Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Jul 9, 2021 Accepting new patients
Icco LLC PastSince Apr 10, 2026 Accepting new patients
Icco, LLC PastSince Apr 10, 2026 Accepting new patients

Locations

6351 W Rio Grande Ave
Kennewick, WA 99336
Phone (509) 543-9280

713 Memorial St
Prosser, WA 99350
Phone (509) 786-1931

1120 W Rose St
Walla Walla, WA 99362
Phone (509) 525-6650

Interoperability endpoints

  • Direct secure messaging: aebner35234@yvfwc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1831717156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6351 W RIO GRANDE AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367634",
            "telephone_number": "509-543-9280",
            "fax_number": "509-579-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048249",
            "telephone_number": "541-216-7291",
            "fax_number": "541-636-2163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6351 W Rio Grande Ave",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993367634",
            "country_code": "US",
            "telephone_number": "509-543-9280",
            "fax_number": "509-579-5915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBNER",
        "first_name": "AUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-13",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61128002",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA222378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aebner35234@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "6351 W Rio Grande Ave",
            "city": "Kennewick",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993367634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.