NPIMap

Individual provider Active NPI

Zachary Caverley, PA

  • Physician Assistant
  • Seaside, OR
National Provider Identifier
1902264559
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA183114 Issued in OR
Practice address
725 S Wahanna Rd
Seaside, OR 97138-7735
Phone
(503) 717-7850
NPI assigned
Feb 10, 2016
Last updated
Sep 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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 5601007683 MI
Physician Assistant 363A00000X PA183114 OR Primary

Addresses

Primary practice location

725 S Wahanna Rd
Seaside, OR 97138-7735

Mailing address

PO Box 3397
Portland, OR 97208-3397

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address zcaverley862147@oc.providencedirect.org
Direct Messaging Address zcaverley862147@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170815004402 OR Practitioner - Physician Assistant 2264738012 Reassigns benefits to 5 organizations

Care Compare profile

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

Practice addresses (Care Compare)

113 S Hwy 101
Warrenton, OR 97146-9314
Phone (503) 861-6500

1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

725 S Wahanna Rd
Seaside, OR 97138-7735
Phone (503) 717-7000

727 S Wahanna Rd
Seaside, OR 97138-7735
Phone (503) 717-7000

9205 SW Barnes Rd
Portland, OR 97225-6603

9427 SW Barnes Rd
Portland, OR 97225-6652

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Feb 1, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 25, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Feb 1, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 25, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 25, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 1, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 1, 2019 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients

Locations

1355 Exchange St
Astoria, OR 97103
Phone (503) 216-2188

10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950

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

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Interoperability endpoints

  • Direct secure messaging: zcaverley862147@oc.providencedirect.org

Organizations & group practices 11

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 12

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": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1902264559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3397",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S WAHANNA RD",
            "city": "SEASIDE",
            "state": "OR",
            "postal_code": "971387735",
            "telephone_number": "503-717-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVERLEY",
        "first_name": "ZACHARY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-10",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007683",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA183114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zcaverley862147@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "725 S Wahanna Rd",
            "city": "Seaside",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971387735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zcaverley862147@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1355 Exchange St",
            "city": "Astoria",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971033980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seaside, OR

Sources for this page

Verify at the official NPI Registry.