Individual provider Active NPI

Thomas Cole Willson Hilliard, PA-C

  • Medical Physician Assistant
  • Oregon City, OR
National Provider Identifier
1982196846
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA196431 Issued in OR
Practice address
1508 Division St Ste 105
Oregon City, OR 97045-1584
Phone
(503) 656-0836
Fax
(503) 656-9464
NPI assigned
Jun 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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 PA196431 OR Primary

Addresses

Primary practice location

1508 Division St Ste 105
Oregon City, OR 97045-1584

Mailing address

2737 SW 1St Ave Apt 2
Portland, OR 97201-4732

Other practice location 1

7401 SW Washo Ct Ste 100
Tualatin, OR 97062-8342
Phone (503) 656-0836

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
I20200122002286 OR Practitioner - Physician Assistant 0244665172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regenerative Orthopedic Center LLCGroup PAC ID 0749640597, 27 clinicians

Practice addresses (Care Compare)

15755 SW Sequoia Pkwy
Suite 200
Tigard, OR 97224-7166
Phone (503) 639-6002

Hospital & facility affiliations

  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA196431ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regenerative Orthopedic Center LLC CurrentSince Feb 13, 2024 Accepting new patients
Regenerative Orthopedic Center LLC CurrentSince Feb 13, 2024 Accepting new patients

Locations

1508 Division St
Ste 105
Oregon City, OR 97045
Phone (503) 656-0836

15755 SW Sequoia Pkwy
Ste 200
Tigard, OR 97224
Phone (503) 639-6002

7401 SW Washo Ct
Ste 100
Tualatin, OR 97062
Phone (503) 656-0836

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 3

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1982196846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2737 SW 1ST AVE APT 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972014732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 DIVISION ST STE 105",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451584",
            "telephone_number": "503-656-0836",
            "fax_number": "503-656-9464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7401 SW Washo Ct Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970628342",
            "country_code": "US",
            "telephone_number": "503-656-0836",
            "fax_number": "503-656-9464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILLIARD",
        "first_name": "THOMAS",
        "middle_name": "COLE WILLSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA196431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

Verify at the official NPI Registry.