Roopa Mukund, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA216572 Issued in OR

Practice address

1445 Gateway Blvd
Cottage Grove, OR 97424-1224

Phone

(541) 942-7000

Fax

(541) 942-7429

NPI assigned

Nov 7, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, CA, OR, MD, VA, DC6 enrollments

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 6

Specialty

Physician Assistant

Education

University of California, Davis School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Urgent Care LLCGroup PAC ID 9335303155, 300 clinicians

Icco LLCGroup PAC ID 1355406729, 133 clinicians

Inova Ucc LLCGroup PAC ID 7012385040, 158 clinicians

Northern Virginia Carenow Urgent Care LLCGroup PAC ID 4284902057, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations (25 of 26)

Interoperability endpoints

• Direct secure messaging: roopa.mukundpac.p11@direct.nextcare.nextgenshare.com
• Direct secure messaging: rmukund1603371@soc.inova.org

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 Care Compare group NPD
• Inova Ucc LLC

  • Urgent Care Clinic/Center
  • Vienna, VA
  • NPI 1508592114

  DC

  Medicare reassignment Care Compare group NPD
• Medstar Urgent Care LLC

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1902175870
  Medicare reassignment Care Compare group NPD
• Northern Virginia Carenow Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Sterling, VA
  • NPI 1548702616

  DC

  Medicare reassignment Care Compare group
• Medstar Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Wheaton, MD
  • NPI 1871843409

  DC

  Medicare reassignment NPD
• Primamed Physicians PLLC

  • Urgent Care Clinic/Center
  • Dallas, TX
  • NPI 1164494068
  Medicare reassignment NPD
• Adventist Health Physicians Network

  • Multi-Specialty Clinic/Center
  • Hanford, CA
  • NPI 1063718583
  Medicare reassignment
• Christiana Care Quality Partners

  • Urgent Care Clinic/Center
  • Newark, DE
  • NPI 1164061867

  MD

  Medicare reassignment
• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment
• Virginia Urgent Care LLC

  • Urgent Care Clinic/Center
  • Fredericksburg, VA
  • NPI 1487838652
  Medicare reassignment
• Adventist Health Physicians Network

  • Physical Therapy Clinic/Center
  • Paradise, CA
  • NPI 1134092190
  NPD
• Adventist Health Physicians Network

  • Surgery Physician
  • Stockton, CA
  • NPI 1821722257
  NPD

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1982172946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 CHATEAUS DR",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194591",
            "telephone_number": "972-896-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 GATEWAY BLVD",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974241224",
            "telephone_number": "541-942-7000",
            "fax_number": "541-942-7429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 N East Plz",
            "address_purpose": "LOCATION",
            "city": "North East",
            "state": "MD",
            "postal_code": "219013633",
            "country_code": "US",
            "telephone_number": "410-656-7867",
            "fax_number": "443-877-6784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12581 Milstead Way Ste 103",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221925446",
            "country_code": "US",
            "telephone_number": "703-897-5890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUKUND",
        "first_name": "ROOPA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009349",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA13220",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56233",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009790",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA216572",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "56233",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Montgomery, MPA
• Tia Rae Morehouse, EPDH
• Kimberly Sue Morton
• Michael L Moser, M.D.
• Abigail Rae Moten, RN
• Bridget K Murphy
• Genevieve Murstig
• Jordyn Nelson, PHARMD
• CHI Nguyen
• Peter Nicholson

• Medical Physician Assistant in Cottage Grove, OR
• Providers in Cottage Grove, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.