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KAMYLLI J MENDIVE PA-C
NPI 1821653254
Physician Assistant in Tigard, OR

Active since May 01, 2019PECOS EnrolledAccepts Medicare Assignment
12442 SW SCHOLLS FERRY RD STE 100, TIGARD, OR 97223(503) 216-9200 Get Directions Write a Review

NPPES record last updated: September 30, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 30, 2024, Jan 18, 2021, Jan 11, 2021 and 1 more (4 updates tracked since 2019).

About Kamylli J Mendive Pa-c NPPES

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

KAMYLLI J MENDIVE PA-C (NPI 1821653254) is an individual physician assistant in Tigard, Oregon, licensed in Oregon (PA202793) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, is affiliated with Providence St Vincent Medical Center, and is a graduate of Oregon Health Sciences University School Of Medicine (2020).

NPPES Registry Identity

NPI1821653254
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKAMYLLI J MENDIVECredential: PA-C
Location Address12442 SW SCHOLLS FERRY RD STE 100Tigard, OR 97223-0803
Mailing AddressPo Box 3158Portland, OR 97208-3158 · (503) 215-6494
Phone(503) 216-9200
Sole ProprietorNo
Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2020
Enumeration DateMay 1, 2019
Last NPPES UpdateSeptember 30, 20244 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2024
✔ NPI 1821653254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in OR · PA202793✔ Licensed in CA · 58813
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
12442 SW SCHOLLS FERRY RD STE 100, Tigard, OR 97223
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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

Kamylli J Mendive 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 ID8527472042
PECOS Enrollment IDI20240710003192
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 2

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 moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
69 services61 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.
23 services22 patients

Hospital Affiliations CMS Care Compare 3

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, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380004
Location9205 SW Barnes RoadPortland, OR 97225 · Washington County
Emergency services Birthing friendly

Providence Newberg Medical Center

Acute Care Hospitals · Newberg, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number380037
Location1001 Providence DriveNewberg, OR 97132 · Yamhill 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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97223 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 6

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
22 suppliers67 claims148 services$5.77 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
15 suppliers34 claims34 services$0.99 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
2 suppliers14 claims28 services$1.18 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier17 claims17 services$56.48 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
3 suppliers18 claims1,170 services$0.09 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
3 suppliers18 claims18 services$23.08 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

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

MATTHEW R WILLIAMS M.D.
Emergency Medicine
12442 SW SCHOLLS FERRY RD STE 100
TIGARD, OR 97223
Washington County (503) 216-9254
MARTHA PATRICE GEISHEKER ANP
Nurse Practitioner (Adult Health)
12442 SW SCHOLLS FERRY RD STE 100
TIGARD, OR 97223
Washington County (503) 216-9200
STACEY ANN WILLIAMSON PA-C
Physician Assistant
12442 SW SCHOLLS FERRY RD STE 100
TIGARD, OR 97223
Washington County (503) 216-9200
STEPHANIE NICOLE D'ANDREA AGPCNP
Nurse Practitioner (Adult Health)
12442 SW SCHOLLS FERRY RD STE 100
TIGARD, OR 97223
Washington County (503) 216-9200
MR. ENRIQUE BARRERA JR. FNP
Nurse Practitioner (Family)
12442 SW SCHOLLS FERRY RD STE 100
TIGARD, OR 97223
Washington County (503) 215-9900
MORGAN ELLIOTT
Registered Nurse
12442 SW SCHOLLS FERRY RD STE 100
TIGARD, OR 97223
Washington County (503) 216-9200
EMILY H JACOBSON PHD
Psychologist (Clinical)
12442 SW SCHOLLS FERRY RD STE 100
TIGARD, OR 97223
Washington County (503) 216-9200
JESSICA J PAXTON PSYD
Psychologist (Clinical)
12442 SW SCHOLLS FERRY RD STE 100
TIGARD, OR 97223
Washington County (503) 216-9200

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 Kamylli Mendive's NPI number?

The NPI number for Kamylli Mendive is 1821653254. It was assigned to this individual provider in the NPPES registry on May 1, 2019.

Where is Kamylli Mendive located?

Kamylli Mendive practices at 12442 SW Scholls Ferry Rd Ste 100, Tigard, OR 97223. The listed phone number is (503) 216-9200.

What is Kamylli Mendive's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kamylli Mendive enrolled in Medicare?

Yes. Kamylli Mendive 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 Kamylli Mendive accept?

Health plans from Providence Health Plan list Kamylli Mendive 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 Kamylli Mendive affiliated with any hospitals?

According to CMS data, Kamylli Mendive is affiliated with Providence St Vincent Medical Center, Providence Newberg Medical Center and Providence Portland Medical Center.

When was this NPI record last updated?

The NPPES record for Kamylli Mendive was last updated on September 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.