MARY ELLEN SPENCER PA-C
NPI 1124619283
Physician Assistant - Medical in Portland, OR

Active since February 01, 2021PECOS EnrolledAccepts Medicare Assignment
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 418-4500(503) 494-1678 Get Directions Write a Review

NPPES record last updated: April 9, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 9, 2024, Feb 1, 2021 (2 updates tracked since 2021).

About Mary Ellen Spencer Pa-c NPPES

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

MARY ELLEN SPENCER PA-C (NPI 1124619283) is an individual medical provider in Portland, Oregon, licensed in Oregon (PA217576) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in New York, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1124619283
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMARY ELLEN SPENCERCredential: PA-C
Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3011
Mailing Address1400 Sw 5th Ave Ste 500Portland, OR 97201-5537 · (866) 617-6855 · Fax (503) 346-8015
Fax(503) 494-1678
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateFebruary 1, 2021
Last NPPES UpdateApril 9, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 18, 2021
NPI 1124619283 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in OR · PA217576
Also ListedPhysician AssistantTaxonomy 363A00000X · License 025656 (NY)
Also ListedNurse PractitionerTaxonomy 363L00000X · License 025656 (NY)
3181 SW SAM JACKSON PARK RD, Portland, OR 97239

Secondary Practice Location 1

Location 11 Gustave L Levy PlNew York, NY 10029-6504 · Phone (212) 241-6500

Accepted 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

Mary Ellen Spencer 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 ID6800202672
PECOS Enrollment IDI20240312003750
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.

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.

Emergency Medicine
3181 SW SAM JACKSON PARK RD, # L-102
PORTLAND, OR 97239
Emergency Medicine
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Nurse Practitioner (Family)
3181 SW SAM JACKSON PARK RD, CDW-EM
PORTLAND, OR 97239
Emergency Medicine
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Emergency Medicine
3181 SW SAM JACKSON PARK RD, MAILCODE CDW-EM
PORTLAND, OR 97239
Emergency Medicine
3181 SW SAM JACKSON PARK RD, # CDW
PORTLAND, OR 97239
Emergency Medicine
3181 SW SAM JACKSON PARK RD, MAIL CODE: CDW-EM
PORTLAND, OR 97239
Emergency Medicine (Medical Toxicology)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124619283, enumerated as an "individual" on February 01, 2021.

The provider is located at 3181 SW SAM JACKSON PARK RD PORTLAND, OR 97239 and the phone number is (503) 418-4500.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

The provider might be accepting Accepts: BridgeSpan Health Company, Moda Health Plan, Inc.. Please consult your insurance carrier or call the provider to verify.