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HOLLY P JASTAK RN, MSN, FNP
NPI 1023541869
Nurse Practitioner - Family in Portland, OR

Active since April 08, 2017PECOS Enrolled
2800 N VANCOUVER AVE STE 165, PORTLAND, OR 97227(503) 413-2902(503) 413-5220 Get Directions Write a Review

NPPES record last updated: April 4, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Holly P Jastak Rn, Msn, Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLLY P JASTAK RN, MSN, FNP (NPI 1023541869) is an individual family provider in Portland, Oregon, licensed in Oregon (201703454NP-PP) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023541869
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameHOLLY P JASTAKCredential: RN, MSN, FNP
Location Address2800 N VANCOUVER AVE STE 165Portland, OR 97227-1644
Mailing AddressPo Box 4399Portland, OR 97208-4399 · (503) 413-3900 · Fax (503) 413-3710
Phone(503) 413-2902
Fax(503) 413-5220
Sole ProprietorYes
Enumeration DateApril 8, 2017
Last NPPES UpdateApril 4, 2019
✔ NPI 1023541869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OR · 201703454NP-PP
2800 N VANCOUVER AVE STE 165, Portland, OR 97227
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, BridgeSpan Health Company, Moda Health Plan, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Holly P Jastak Rn, Msn, Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

6

Medicare enrollment records show Holly Jastak reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Legacy Emanuel Hospital & Health Center
Same address
Clinic/Center
2800 N VANCOUVER AVE STE 230
Portland, OR 97227
  • Reassigned Medicare billing, Oregon enrollment
  • 719 clinicians in this Medicare group
NPI 1700809027 (503) 397-0471
Legacy Clinics LLC
1.6 mi
Clinic/Center
1130 NW 22ND AVE STE 220
Portland, OR 97210
  • Reassigned Medicare billing, Oregon enrollment
  • 1,248 clinicians in this Medicare group
NPI 1902827272 (503) 413-2901
Northwest Acute Care Specialists PC
2.0 mi
Emergency Medicine
101 SW MAIN ST STE 940
Portland, OR 97204
  • Reassigned Medicare billing, Oregon and Washington enrollments
  • 163 clinicians in this Medicare group
NPI 1215983200 (503) 464-9034
Providence Health & Services - Oregon
13 mi
Clinical Pathology
1500 DIVISION ST
Oregon City, OR 97045
  • Reassigned Medicare billing, Oregon enrollment
  • 206 clinicians in this Medicare group
NPI 1003368911 (503) 656-1631
Providence Health & Services - Oregon
21 mi
Clinical Pathology
1001 PROVIDENCE DR
Newberg, OR 97132
  • Reassigned Medicare billing, Oregon enrollment
  • 198 clinicians in this Medicare group
NPI 1174074868 (503) 537-1555
Banner Childrens Banner Health Clinic LLC
1,005 mi
Primary Care
2901 N CENTRAL AVE STE 160
Phoenix, AZ 85012
  • Reassigned Medicare billing, Arizona enrollment
  • 57 clinicians in this Medicare group
NPI 1285278077 (602) 747-4000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97227 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAURA FERN BYLER LISW
Social Worker
2800 N VANCOUVER AVE STE 165
PORTLAND, OR 97227
Multnomah County (503) 413-2902
CARMEN ELIAS-FRANCISCO
Community Health Worker
2800 N VANCOUVER AVE STE 165
PORTLAND, OR 97227
Multnomah County (503) 413-5490
LAURA MICHELLE DART M.D.
Pediatrics
2800 N VANCOUVER AVE STE 165
PORTLAND, OR 97227
Multnomah County (503) 413-2902
JACOB WICKS
Social Worker (Clinical)
2800 N VANCOUVER AVE STE 165
PORTLAND, OR 97227
Multnomah County (503) 413-2902

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Holly Jastak's NPI number?

The NPI number for Holly Jastak is 1023541869. It was assigned to this individual provider in the NPPES registry on April 8, 2017.

Where is Holly Jastak located?

Holly Jastak practices at 2800 N Vancouver Ave Ste 165, Portland, OR 97227. The listed phone number is (503) 413-2902.

What is Holly Jastak's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Holly Jastak enrolled in Medicare?

Yes. Holly Jastak is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Holly Jastak's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Holly Jastak reassigns Medicare benefits to 6 organizations: Legacy Emanuel Hospital & Health Center (Portland, OR), Legacy Clinics LLC (Portland, OR), Northwest Acute Care Specialists PC (Portland, OR), Providence Health & Services - Oregon (Oregon City, OR), Providence Health & Services - Oregon (Newberg, OR) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Holly Jastak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Holly Jastak accept?

Health plans from Blue Cross Blue Shield of Arizona, BridgeSpan Health Company, Moda Health Plan, Inc., Oscar Health Plan, Inc. and PacificSource Health Plans and 3 other insurers list Holly Jastak as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Holly Jastak was last updated on April 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.