Individual provider Active NPI

Jason Ludlow

  • Student in an Organized Health Care Education/Training Program
  • Hillsboro, OR
National Provider Identifier
1952924938
Registry record updated May 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
222 SE 8TH Ave Ste 536
Hillsboro, OR 97123-4218
Phone
(503) 352-7299
NPI assigned
May 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

222 SE 8TH Ave Ste 536
Hillsboro, OR 97123-4218

Mailing address

74 W 100 S
Spanish Fork, UT 84660-2003
Phone (702) 412-0661

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
I20221221002444 OR Practitioner - Physician Assistant 3274903927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Pacific Medical College, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Clinic PCGroup PAC ID 3577559012, 14 clinicians

Practice addresses (Care Compare)

2441 Grear St NE
Salem, OR 97301-2749
Phone (503) 364-3321

2441 Grear St Northeast
Salem, OR 97301-2749

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

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 1

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": "1590364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590364800000",
    "number": "1952924938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 W 100 S",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846602003",
            "telephone_number": "702-412-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SE 8TH AVE STE 536",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234218",
            "telephone_number": "503-352-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDLOW",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-25",
        "last_updated": "2020-05-25",
        "certification_date": "2020-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.