CARLI MCCORMICK PA
NPI 1972329563
Physician Assistant in Lake Oswego, OR

Q: What is Carli Mccormick's NPI number?

The NPI number for Carli Mccormick is 1972329563. It was assigned to this individual provider in the NPPES registry on November 27, 2024.

Q: What is Carli Mccormick's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Carli Mccormick was last updated on January 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since November 27, 2024PECOS EnrolledAccepts Medicare Assignment

4103 MERCANTILE DR, LAKE OSWEGO, OR 97035(503) 850-9940 Get Directions Write a Review

NPPES record last updated: January 5, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 5, 2025, Dec 20, 2024 (2 updates tracked since 2024).

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About Carli Mccormick Pa NPPES

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

CARLI MCCORMICK PA (NPI 1972329563) is an individual physician assistant in Lake Oswego, Oregon, licensed in Oregon (PA222750) and active in the NPI registry since November 2024. She is enrolled in Medicare PECOS, is affiliated with Legacy Emanuel Medical Center, and is a graduate of Touro Un Col Of Osteopathic Medicine, Henderson (2024).

NPPES Registry Identity

NPI1972329563

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameCARLI MCCORMICKCredential: PA

Location Address4103 MERCANTILE DRLake Oswego, OR 97035-2556

Mailing Address4103 Mercantile DrLake Oswego, OR 97035-2556

Phone(503) 850-9940

Sole ProprietorNo

Medical School CMSTouro Un Col Of Osteopathic Medicine, HendersonGraduated 2024

Enumeration DateNovember 27, 2024

Last NPPES UpdateJanuary 5, 20252 updates tracked since enumeration

NPPES CertifiedJanuary 5, 2025

✔ NPI 1972329563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in OR · PA222750

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.

4103 MERCANTILE DR, Lake Oswego, OR 97035

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Accepted Insurance

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

Carli Mccormick Pa 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 ID3274054945

PECOS Enrollment IDI20250311000639

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.

Hospital Affiliations CMS Care Compare 3

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 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

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97035 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.

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.

MISS AMANDA MAGDALENA KINDER FNP-C

Nurse Practitioner (Family)