MADISON MARIE MABRY PAC
NPI 1194348219
Physician Assistant - Surgical in Portland, OR

Q: What is Madison Mabry's NPI number?

The NPI number for Madison Mabry is 1194348219. It was assigned to this individual provider in the NPPES registry on May 22, 2020.

Q: What is Madison Mabry's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Madison Mabry was last updated on May 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.

Active since May 22, 2020PECOS EnrolledAccepts Medicare Assignment

5050 NE HOYT ST STE 340, PORTLAND, OR 97213(503) 238-1061(503) 238-0841 Get Directions Write a Review

NPPES record last updated: May 15, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 15, 2026, Apr 21, 2026, Nov 5, 2024 and 4 more (7 updates tracked since 2020).

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About Madison Marie Mabry Pac NPPES

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

MADISON MARIE MABRY PAC (NPI 1194348219) is an individual surgical provider in Portland, Oregon, licensed in Oregon (PA213704) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS, is affiliated with Providence Portland Medical Center, and maintains a secondary practice location in Beaverton.

NPPES Registry Identity

NPI1194348219

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameMADISON MARIE MABRYCredential: PAC

Location Address5050 NE HOYT ST STE 340Portland, OR 97213-2983

Mailing Address541 Ne 20th Ave Ste 225Portland, OR 97232-2895 · (503) 963-2801 · Fax (503) 963-2825

Phone(503) 238-1061

Fax(503) 238-0841

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateMay 22, 2020

Last NPPES UpdateMay 15, 20267 updates tracked since enumeration

NPPES CertifiedMay 15, 2026

✔ NPI 1194348219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363AS0400X

License✔ Licensed in OR · PA213704

5050 NE HOYT ST STE 340, Portland, OR 97213

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Secondary Practice Location 1

Location 111000 SW Stratus St Ste 210Beaverton, OR 97008-7106 · Phone (503) 238-1061 · Fax (503) 238-0841

Other Identifiers 2

Medicaid2226231WA

Medicaid500812454OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan 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

Madison Marie Mabry Pac 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 ID8820467442

PECOS Enrollment IDI20221202002277

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 5

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

620 services64 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

100 services66 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.

80 services63 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

27 services26 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

18 services18 patients

Hospital Affiliations CMS Care Compare

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

Providence Portland Medical Center

Acute Care Hospitals · Portland, OR

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380061

Location4805 NE Glisan StreetPortland, OR 97213 · Multnomah County

Emergency services Birthing friendly

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Other Providers at the Same Location NPPES 15

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

SEAN PATRICK CONLEY PA-C

Physician Assistant (Surgical)