Individual provider Active NPI

McKayla Pollard

  • Physician Assistant
  • Salem, OR
National Provider Identifier
1952995763
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA211171 Issued in OR
Practice address
4999 Skyline Rd S
Salem, OR 97306-2878
Phone
(503) 364-4005
Fax
(503) 364-4006
NPI assigned
Feb 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA211171 OR Primary

Addresses

Primary practice location

4999 Skyline Rd S
Salem, OR 97306-2878

Mailing address

PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119

Other practice location 1

2730 S Moody Ave
Portland, OR 97201-5042
Phone (503) 851-8223

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
I20221213003166 OR Practitioner - Physician Assistant 1658740600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Oregon Health Sciences University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

354 W Adams Ave
Sisters, OR 97759-2619
Phone (541) 549-9609

4999 Skyline Rd S
Suite 100
Salem, OR 97306-0001
Phone (503) 364-4005

Hospital & facility affiliations

  • First Call Home Health Agency, LLC Home health agency, Salem, OR, CCN 387147
  • Salem Hospital Hospital, Salem, OR, CCN 380051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA211171ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Praxis Health, PC CurrentSince Jan 9, 2023 Accepting new patients
Praxis Health, PC CurrentSince Jan 9, 2023 Accepting new patients

Locations

4999 Skyline Rd S
Salem, OR 97306
Phone (503) 364-4005

4999 Skyline Rd S
Ste 100
Salem, OR 97306
Phone (503) 364-4005

Organizations & group practices 2

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 2

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": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1952995763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4999 SKYLINE RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973062878",
            "telephone_number": "503-364-4005",
            "fax_number": "503-364-4006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2730 S Moody Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972015042",
            "country_code": "US",
            "telephone_number": "503-851-8223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLLARD",
        "first_name": "MCKAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-22",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA211171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.