AYUMI MIZUNO AGNP-C
NPI 1215730031
Nurse Practitioner - Adult Health in Tualatin, OR
About Ayumi Mizuno Agnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AYUMI MIZUNO AGNP-C (NPI 1215730031) is an individual adult health provider in Tualatin, Oregon, licensed in Oregon (10031967) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS, is affiliated with Providence St Vincent Medical Center, and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ayumi Mizuno Agnp-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.
Medicare Billing Reassignment
Medicare enrollment records show Ayumi Mizuno reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Tualatin, OR 97062
- Reassigned Medicare billing, Oregon enrollment
- 3 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Providence St Vincent Medical Center
Acute Care Hospitals · Portland, ORProvidence Newberg Medical Center
Acute Care Hospitals · Newberg, ORProvidence Willamette Falls Medical Center
Acute Care Hospitals · Oregon City, ORSalem Hospital
Acute Care Hospitals · Salem, ORLegacy Meridian Park Medical Center
Acute Care Hospitals · Tualatin, ORPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97062 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
TUALATIN, OR 97062
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 Ayumi Mizuno's NPI number?
The NPI number for Ayumi Mizuno is 1215730031. It was assigned to this individual provider in the NPPES registry on March 28, 2025.
Where is Ayumi Mizuno located?
Ayumi Mizuno practices at 7790 SW Mohawk St, Tualatin, OR 97062. The listed phone number is (503) 885-1515.
What is Ayumi Mizuno's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Ayumi Mizuno enrolled in Medicare?
Yes. Ayumi Mizuno is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Ayumi Mizuno's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ayumi Mizuno reassigns Medicare benefits to Spinal Diagnostics PC (Tualatin, OR). The 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 Ayumi Mizuno's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ayumi Mizuno accept?
Health plans from BridgeSpan Health Company, PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Ayumi Mizuno 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.
Is Ayumi Mizuno affiliated with any hospitals?
According to CMS data, Ayumi Mizuno is affiliated with Providence St Vincent Medical Center, Providence Newberg Medical Center, Providence Willamette Falls Medical Center, Salem Hospital and Legacy Meridian Park Medical Center.
When was this NPI record last updated?
The NPPES record for Ayumi Mizuno was last updated on February 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Ayumi Mizuno, AGNP-C · NPI 1215730031
Adult Health physician in Tualatin, Oregon. Individual provider, active in the CMS NPPES registry since March 28, 2025.
## Identity
- **NPI:** 1215730031 (Entity type: Individual)
- **Enumerated:** March 28, 2025
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** 10031967 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 7790 SW MOHAWK ST, Tualatin, OR 97062-9191
- **Phone:** (503) 885-1515 · **Fax:** (503) 885-1520
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Spinal Diagnostics PC (NPI 1194751735, Tualatin, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** February 23, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1215730031) · Data from the CMS NPPES public registry.