1. Home
  2. Directory
  3. Oregon
  4. Portland
  5. Physician Assistant
  6. NPI Profile

CARLY JANE KING GRAVEL
NPI 1629635008
Physician Assistant - Medical in Portland, OR

Active since May 21, 2019PECOS EnrolledAccepts Medicare Assignment
97.83/100
CMS Quality Rating
3303 S BOND AVE, PORTLAND, OR 97239(503) 494-6594(503) 494-5385 Get Directions Write a Review

NPPES record last updated: September 18, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Sep 18, 2025, Mar 20, 2023, Feb 15, 2023 and 2 more (5 updates tracked since 2019).

About Carly Jane King Gravel NPPES

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

CARLY JANE KING GRAVEL (NPI 1629635008) is an individual medical provider in Portland, Oregon, licensed in Oregon (PA207931) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, is affiliated with Ohsu Hospital And Clinics, and maintains a secondary practice location in Stanford.

NPPES Registry Identity

NPI1629635008
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameCARLY JANE KING GRAVEL
Location Address3303 S BOND AVEPortland, OR 97239-4501
Mailing Address1400 Sw 5th Ave Ste 500Portland, OR 97201-5537 · (866) 617-6855 · Fax (503) 346-8015
Phone(503) 494-6594
Fax(503) 494-5385
Sole ProprietorNo
Medical School CMSStanford University School Of MedicineGraduated 2012
Enumeration DateMay 21, 2019
Last NPPES UpdateSeptember 18, 20255 updates tracked since enumeration
NPPES CertifiedSeptember 18, 2025
✔ NPI 1629635008 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
Licenses✔ Licensed in OR · PA207931✔ Licensed in CA · 58259
3303 S BOND AVE, Portland, OR 97239
Open in Google Maps ↗

Other Names 1

Former Name (1)Carly Jane King Pa

Secondary Practice Location 1

Location 1300 Pasteur DrStanford, CA 94305-2200 · Phone (650) 498-6000

Accepted Insurance

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

Carly Jane King Gravel 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 ID2668891367
PECOS Enrollment IDI20230501002731
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

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 high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
354 services97 patients

Hospital Affiliations CMS Care Compare

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

Ohsu Hospital And Clinics

Acute Care Hospitals · Portland, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number380009
Location3181 SW Sam Jackson Park RoadPortland, OR 97239 · Multnomah County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.83/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.97
Promoting Interoperability100
Improvement Activities40

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.

CHERYL STOMBERG FNP
Nurse Practitioner (Family)
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 494-6594
KIT MIRANDA
Speech-Language Pathologist
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 494-5947
MRS. LINDSAY EVELYN WYANT PAC
Physician Assistant (Surgical)
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 494-8510
MS. STEFANIE ANN BROWN L.C.S.W.
Social Worker (Clinical)
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 494-1775
DR. MELISSA DANIELLE ADAIR ARNP
Nurse Practitioner (Family)
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 418-3376
EMMA MARIANE JONES
Physician Assistant (Medical)
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 494-8573
EMMA JO NEUMANN
Social Worker (Clinical)
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 418-7730
MICHAEL ZATT
Psychiatry & Neurology (Neurology)
3303 S BOND AVE
PORTLAND, OR 97239
Multnomah County (503) 494-7772

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 Carly Gravel's NPI number?

The NPI number for Carly Gravel is 1629635008. It was assigned to this individual provider in the NPPES registry on May 21, 2019. The provider is also known as Carly Jane King PA.

Where is Carly Gravel located?

Carly Gravel practices at 3303 S Bond Ave, Portland, OR 97239. The listed phone number is (503) 494-6594.

What is Carly Gravel's specialty?

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

Is Carly Gravel enrolled in Medicare?

Yes. Carly Gravel 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.

What insurance does Carly Gravel accept?

Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Carly Gravel 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 Carly Gravel affiliated with any hospitals?

According to CMS data, Carly Gravel is affiliated with Ohsu Hospital And Clinics.

When was this NPI record last updated?

The NPPES record for Carly Gravel was last updated on September 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.