NPIMap

Individual provider Active NPI

Kristofer R McAllister, PA-C

  • Medical Physician Assistant
  • Gresham, OR
National Provider Identifier
1972567725
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA01078 Issued in OR
Practice address
831 NW Council Dr Ste 145
Gresham, OR 97030-3795
Phone
(503) 666-6717
Fax
(503) 666-6745
NPI assigned
Apr 17, 2006
Last updated
Feb 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA01078 OR Primary

Addresses

Primary practice location

831 NW Council Dr Ste 145
Gresham, OR 97030-3795

Mailing address

1815 E 19TH St Ste B
The Dalles, OR 97058-3385
Phone (541) 316-6575

Other practice location 1

1815 E 19th St Ste B
The Dalles, OR 97058-3385
Phone (541) 316-6575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2026 through Apr 1, 2028

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Redwoods Rural Health Center IncGroup PAC ID 6709867583, 13 clinicians

Practice addresses (Care Compare)

930 S Fortuna Blvd
Fortuna, CA 95540-3009
Phone (707) 923-2783

PO Box
Redway, CA 95560

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01078ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Healthcare Associates, LLC PastSince Apr 5, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kmcallister827432@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1972567725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 E 19TH ST STE B",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583385",
            "telephone_number": "541-316-6575",
            "fax_number": "541-210-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 NW COUNCIL DR STE 145",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303795",
            "telephone_number": "503-666-6717",
            "fax_number": "503-666-6745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1815 E 19th St Ste B",
            "address_purpose": "LOCATION",
            "city": "The Dalles",
            "state": "OR",
            "postal_code": "970583385",
            "country_code": "US",
            "telephone_number": "541-316-6575",
            "fax_number": "541-210-8913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCALLISTER",
        "first_name": "KRISTOFER",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA01078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.