NPIMap

Individual provider Active NPI

Amanda DO Huang, PA

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1942715487
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA183840 Issued in OR
Practice address
11790 SW Barnes Rd Ste 330
Portland, OR 97225-5935
Phone
(503) 228-4414
Fax
(503) 228-7293
NPI assigned
Dec 6, 2017
Last updated
Jul 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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 PA183840 OR Primary

Addresses

Primary practice location

11790 SW Barnes Rd Ste 330
Portland, OR 97225-5935

Mailing address

11790 SW Barnes Rd Ste 330
Portland, OR 97225-5935
Phone (503) 228-4414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20231017003679 OK Practitioner - Physician Assistant 6204169030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3400 NW Expressway
Suite 500
Oklahoma City, OK 73112-4492
Phone (405) 945-4589

4221 S Western
3010 Southwest Rehab
Oklahoma City, OK 73109-3492
Phone (405) 636-7452

4221 S Western Ave
Oklahoma City, OK 73109-3492

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Helens Internal Medicine Past Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients
Office of Integrative Medicine, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ahuang475276@direct.integrisok.com

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, 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": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1942715487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11790 SW BARNES RD STE 330",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255935",
            "telephone_number": "503-228-4414",
            "fax_number": "503-228-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11790 SW BARNES RD STE 330",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255935",
            "telephone_number": "503-228-4414",
            "fax_number": "503-228-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "AMANDA",
        "middle_name": "DO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA183840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.