Individual provider Active NPI

Abigail Marie Pardo, NP

  • Adult Health Nurse Practitioner
  • Gresham, OR
National Provider Identifier
1861087538
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
202100429NP Issued in OR
Practice address
24800 SE Stark St
Gresham, OR 97030-3378
Phone
(503) 413-8407
NPI assigned
Mar 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 202100429NP-PP OR
Adult Health Nurse Practitioner 363LA2200X 202100429NP OR Primary

Addresses

Primary practice location

24800 SE Stark St
Gresham, OR 97030-3378

Mailing address

PO Box 4365
Portland, OR 97208-4365
Phone (503) 413-3900

Other names 1

  • Abigail Garrow Former name

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
I20210413002989 OR Practitioner - Nurse Practitioner 9032527924 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Mount Hood Medical CenterGroup PAC ID 3173515996, 58 clinicians

Practice addresses (Care Compare)

24988 SE Stark St
Suite 220
Gresham, OR 97030-8324
Phone (503) 674-1580

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
202100429NPORMDAdult Health Nurse Practitioner
202100429NP-PPORMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Mount Hood Medical Center CurrentSince Mar 26, 2023 Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Jan 3, 2022 Accepting new patients
Legacy Clinics LLC CurrentSince Apr 6, 2021 Accepting new patients

Locations

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

24988 SE Stark St
Ste 220
Gresham, OR 97030
Phone (503) 674-1580

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

Interoperability endpoints

  • Direct secure messaging: agarrow102452@direct.lhs.org

Organizations & group practices 3

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 2

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": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1861087538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4365",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084365",
            "telephone_number": "503-413-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24800 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303378",
            "telephone_number": "503-413-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDO",
        "first_name": "ABIGAIL",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "202100429NP-PP",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "202100429NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "GARROW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.