TRACY DODGE PA-C, MPH
NPI 1679023519
Physician Assistant - Medical in Portland, OR
About Tracy Dodge Pa-c, Mph NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TRACY DODGE PA-C, MPH (NPI 1679023519) is an individual medical provider in Portland, Oregon, licensed in Oregon (PA190591) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tracy Dodge Pa-c, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
PORTLAND, OR 97209
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 Tracy Dodge's NPI number?
The NPI number for Tracy Dodge is 1679023519. It was assigned to this individual provider in the NPPES registry on October 4, 2016.
Where is Tracy Dodge located?
Tracy Dodge practices at 727 W Burnside St, Portland, OR 97209. The listed phone number is (503) 228-4533.
What is Tracy Dodge's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Tracy Dodge enrolled in Medicare?
Yes. Tracy Dodge is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Tracy Dodge was last updated on July 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.
# Tracy Dodge, PA-C, MPH · NPI 1679023519
Medical physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since October 4, 2016.
## Identity
- **NPI:** 1679023519 (Entity type: Individual)
- **Enumerated:** October 4, 2016
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** PA190591 (Oregon)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 727 W BURNSIDE ST, Portland, OR 97209-3514
- **Phone:** (503) 228-4533
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** July 11, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1679023519) · Data from the CMS NPPES public registry.