Alysia I. Privrat, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA160964 Issued in OR

Practice address

10300 NE Hancock St
Portland, OR 97220-3831

Phone

(503) 257-5500

NPI assigned

Oct 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aprivratagency269069@samhealth.direct-ci.com

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.

• Icco, LLC

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment NPD
• CRM Physicians, LLC

  • Internal Medicine Physician
  • Beaverton, OR
  • NPI 1952674996
  Medicare reassignment
• Access Telecare, PLLC

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1013303080

  OR

  Medicare reassignment
• Vibra Physicians LLC

  • Hospitalist Physician
  • Johnstown, CO
  • NPI 1659705424

  OR

  Medicare reassignment
• Access Telecare California, P.C.

  • Neurology Physician
  • Dallas, TX
  • NPI 1861959959

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1942498688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10514 NW 26TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986854817",
            "telephone_number": "646-732-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 NE HANCOCK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203831",
            "telephone_number": "503-257-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3043 NE 28th St",
            "address_purpose": "LOCATION",
            "city": "Lincoln City",
            "state": "OR",
            "postal_code": "973674518",
            "country_code": "US",
            "telephone_number": "541-994-3661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIVRAT",
        "first_name": "ALYSIA",
        "middle_name": "I.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60112485",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "8968",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA160964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aprivratagency269069@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3043 NE 28th St",
            "city": "Lincoln City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973674518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Pritchett, PA
• Don Pritchett
• Jennifer Pritchett
• Lorin Jonathan Pritts, LMFT
• Kimberly A Privitera, DC
• Pro Chiropractic LLC
• Pro Chiropractic LLC
• Pro Wellness Chiropractic, LLC
• Pro-Step Rehab
• Jordan Guy Probasco, D.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.