KENNETH LEE RECKARD PA-C
NPI 1083635916
Physician Assistant - Medical in Tualatin, OR

Q: What is Kenneth Reckard's NPI number?

The NPI number for Kenneth Reckard is 1083635916. It was assigned to this individual provider in the NPPES registry on July 23, 2006.

Q: What is Kenneth Reckard's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Reckard was last updated on December 1, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 23, 2006PECOS EnrolledAccepts Medicare Assignment

19250 SW 90TH AVE, TUALATIN, OR 97062(503) 692-3750(503) 691-2324 Get Directions Write a Review

NPPES record last updated: December 1, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Kenneth Lee Reckard Pa-c NPPES

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

KENNETH LEE RECKARD PA-C (NPI 1083635916) is an individual medical provider in Tualatin, Oregon, licensed in Oregon (PA01082) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Providence Newberg Medical Center, and maintains a secondary practice location in Newberg.

NPPES Registry Identity

NPI1083635916

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameKENNETH LEE RECKARDCredential: PA-C

Location Address19250 SW 90TH AVETualatin, OR 97062-7585

Mailing Address847 Ne 19th Ave, Suite 300Portland, OR 97232-2684 · (503) 963-2801 · Fax (503) 963-2801

Phone(503) 692-3750

Fax(503) 691-2324

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateJuly 23, 2006

Last NPPES UpdateDecember 1, 2021

NPPES CertifiedDecember 1, 2021

✔ NPI 1083635916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in OR · PA01082

19250 SW 90TH AVE, Tualatin, OR 97062

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Secondary Practice Location 1

Location 1879 N Providence DrNewberg, OR 97132-7563 · Phone (503) 692-3750 · Fax (503) 691-2324

Other Identifiers 2

Medicaid1083635916WA

Medicaid500604351OR

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kenneth Lee Reckard Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4688699085

PECOS Enrollment IDI20051013000722

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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

90 services89 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

78 services73 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

60 services60 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Providence Newberg Medical Center

Acute Care Hospitals · Newberg, OR

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number380037

Location1001 Providence DriveNewberg, OR 97132 · Yamhill County

Emergency services Birthing friendly

Legacy Meridian Park Medical Center

Acute Care Hospitals · Tualatin, OR

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380089

Location19300 SW 65th AvenueTualatin, OR 97062 · Washington County

Emergency services Birthing friendly

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Other Providers at the Same Location NPPES 20

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

JESSICA KAZUE HARAGA MD

Internal Medicine (Gastroenterology)