BRUCE FERNSTROM PA-C
NPI 1255329967
Physician Assistant - Surgical in Portland, OR

Q: What is Bruce Fernstrom's NPI number?

The NPI number for Bruce Fernstrom is 1255329967. It was assigned to this individual provider in the NPPES registry on October 7, 2005.

Q: What is Bruce Fernstrom'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 Bruce Fernstrom was last updated on July 28, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 07, 2005PECOS EnrolledAccepts Medicare Assignment

501 N GRAHAM ST STE 420, PORTLAND, OR 97227(503) 288-7303(503) 288-3806 Get Directions Write a Review

NPPES record last updated: July 28, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 5, 2023, Dec 1, 2021, Nov 24, 2015 (3 updates tracked since 2015).

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About Bruce Fernstrom Pa-c NPPES

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

BRUCE FERNSTROM PA-C (NPI 1255329967) is an individual surgical provider in Portland, Oregon, licensed in Oregon (PA00805) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Legacy Emanuel Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1255329967

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameBRUCE FERNSTROMCredential: PA-C

Location Address501 N GRAHAM ST STE 420Portland, OR 97227-2006

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

Phone(503) 288-7303

Fax(503) 288-3806

Sole ProprietorNo

Medical School CMSOtherGraduated 2001

Enumeration DateOctober 7, 2005

Last NPPES UpdateJuly 28, 20253 updates tracked since enumeration

NPPES CertifiedJuly 28, 2025

✔ NPI 1255329967 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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

Taxonomy Code363AS0400X

License✔ Licensed in OR · PA00805

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA00805 (OR)

501 N GRAHAM ST STE 420, Portland, OR 97227

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Secondary Practice Locations 2

Location 119250 SW 65th Ave Ste 235Tualatin, OR 97062-7745 · Phone (503) 692-4820 · Fax (503) 612-0793

Location 21130 NW 22nd Ave Ste 400Portland, OR 97210-2971 · Phone (503) 413-6722

Other Identifiers 1

Medicaid500600862OR

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

Bruce Fernstrom 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 ID9537259973

PECOS Enrollment IDI20071221000200

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.

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.

107 services97 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

80 services65 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

78 services71 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.

27 services27 patients

Simple insertion of temporary bladder tube 51702

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

18 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Legacy Emanuel Medical Center

Acute Care Hospitals · Portland, OR

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380007

Location2801 N Gantenbein AvenuePortland, OR 97227 · Multnomah County

Emergency services Birthing friendly

Legacy Good Samaritan Medical Center

Acute Care Hospitals · Portland, OR

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380017

Location1015 NW 22nd Avenue, W121Portland, OR 97210 · Multnomah County

Emergency services Birthing friendly

Legacy Mount Hood Medical Center

Acute Care Hospitals · Gresham, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380025

Location24800 SE Stark StreetGresham, OR 97030 · Multnomah County

Emergency services Birthing friendly

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

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

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

2 suppliers12 claims1,640 services$1.64 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 6

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

DR. JIN-HEE KIM MD

Urology