Dmitriy Viktorovich Vakulchik, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA227608 Issued in OR

Practice address

7300 SW Childs Rd Ste B
Tigard, OR 97224-7772

Phone

(503) 692-8700

Fax

(503) 692-8710

NPI assigned

Feb 25, 2026

Last updated

Mar 12, 2026By the provider in NPPES

Sex

Male

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, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Oregon Sports Medicine Associates

  dba Sports Medicine Oregon

  • Specialist
  • Tigard, OR
  • NPI 1093713729
  Medicare reassignment NPD
• Oregon Sports Medicine Associates

  dba Sports Medicine Oregon

  • Orthopaedic Surgery Physician
  • Wilsonville, OR
  • NPI 1487929741
  NPD (past)

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

{
    "created_epoch": "1771977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1841144805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 SW CHILDS RD STE B",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247772",
            "telephone_number": "503-692-8700",
            "fax_number": "503-692-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 SW CHILDS RD STE B",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247772",
            "telephone_number": "503-692-8700",
            "fax_number": "503-692-8710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29345 SW Town Center Loop E Ste 211",
            "address_purpose": "LOCATION",
            "city": "Wilsonville",
            "state": "OR",
            "postal_code": "970708486",
            "country_code": "US",
            "telephone_number": "503-692-8700",
            "fax_number": "503-692-8710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAKULCHIK",
        "first_name": "DMITRIY",
        "middle_name": "VIKTOROVICH",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-25",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA227608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chidozie Kenneth Urom
• Maximilian Wolfgang Usman
• Saman Vadaei
• Dante H Vaidya
• Brooke Vaille
• Adela Rose Valdes
• Morgan Barnabas Valentine
• Summer Joy Valentine
• Iris Valet, MSW
• Alexandra Valls

• Physician Assistant in Tigard, OR
• Providers in Tigard, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.