Individual provider Active NPI

Amanda Leigh Rissberger

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1851156392
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA218479 Issued in OR
Practice address
2800 N Vancouver Ave Ste 230
Portland, OR 97227-1668
Phone
(503) 413-4340
NPI assigned
Feb 14, 2024
Last updated
Feb 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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 PA218479 OR Primary

Addresses

Primary practice location

2800 N Vancouver Ave Ste 230
Portland, OR 97227-1668

Mailing address

PO Box 4399
Portland, OR 97208-4399
Phone (503) 413-3900

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
I20240308001889 OR Practitioner - Physician Assistant 1254777543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2800 N Vancouver Ave
Suite 230
Portland, OR 97227-1668
Phone (503) 413-4340

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2042

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center CurrentSince Feb 23, 2024 Accepting new patients
Legacy Emanuel Hospital & Health Center Past Accepting new patients

Locations

2800 N Vancouver Ave
Ste 230
Portland, OR 97227
Phone (503) 413-2901

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1851156392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4399",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084399",
            "telephone_number": "503-413-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N VANCOUVER AVE STE 230",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271668",
            "telephone_number": "503-413-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISSBERGER",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA218479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.