Individual provider Active NPI

Amanda S Gay, M.D.

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1912937723
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD23207 Issued in OR
Practice address
12511 SW 68TH Ave Ste 200
Portland, OR 97223-8298
Phone
(503) 675-1137
Fax
(503) 534-1137
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD23207 OR Primary

Addresses

Primary practice location

12511 SW 68TH Ave Ste 200
Portland, OR 97223-8298

Mailing address

12511 SW 68TH Ave Ste 200
Portland, OR 97223-8298
Phone (503) 675-1137

Other identifiers 1

IdentifierTypeStateIssuer
286642MedicaidOR

Other names 1

  • Dr. Amanda S Warren 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041011000265 OR Practitioner - Family Practice 0648239012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD23207ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Meridian Park Hospital CurrentSince Dec 17, 2018 Accepting new patients
Kara M Kassay, MD, PC CurrentSince Apr 20, 2025 Accepting new patients
Patrick a Spensley MD PC Family Medicine Past Accepting new patients
Trent B. Warren, M.D., P.C. Family Medicine Past Accepting new patients

Locations

1433 SE 1st Ave
Canby, OR 97013
Phone (503) 525-7600

12511 SW 68th Ave
Ste 200
Portland, OR 97223
Phone (503) 675-1137

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

Interoperability endpoints

  • Direct secure messaging: awarren11624@direct.lhs.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1912937723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12511 SW 68TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238298",
            "telephone_number": "503-675-1137",
            "fax_number": "503-534-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12511 SW 68TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238298",
            "telephone_number": "503-675-1137",
            "fax_number": "503-534-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAY",
        "first_name": "AMANDA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD23207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286642",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WARREN",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.