MR. TODD B MACLEOD (NPI# 1538426499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1538426499 |
Entity Type | Individual |
Full Name | MR. TODD B MACLEOD |
Credential | PA |
Practice Address |
4103 Mercantile Dr Lake Oswego OR 97035-2556 |
Practice Telephone | 5038509940 |
Practice Fax Number | 5038506709 |
Mailing Telephone | 5038509940 |
Mailing Fax Number | 5038506709 |
Enumeration Date | 2012-04-17 |
Last Update Date | 2019-06-11 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | PA174736 | OR | Physician Assistants & Advanced Practice Nursing Providers |
N | 363A00000X | Physician Assistant | 006438 | GA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | P01105699 | RAILROAD MEDICARE | 01 |
GA | 003123101F | 05 | |
GA | 003123101D | 05 | |
GA | 003123101A | 05 | |
GA | 003123101B | 05 | |
GA | 003123101C | 05 | |
OR | 500725730 | 05 | |
GA | WELLCARE | 685394 | 01 |
Street Address |
4103 MERCANTILE DR |
City | LAKE OSWEGO |
State | OR |
Zip Code | 97035-2556 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548296593 | Amer J Mirza | Orthopaedic Surgery | 4103 Mercantile Dr, Lake Oswego, OR 97035-2556 | 2006-06-23 |
1841817541 | Adele E Smith | Registered Nurse | 4103 Mercantile Dr, Lake Oswego, OR 97035-2556 | 2020-06-29 |
1740842467 | Craig T Gillis Do PC | Orthopaedic Surgery | 4103 Mercantile Dr, Lake Oswego, OR 97035-2556 | 2019-07-02 |
1356850267 | Tasha Stark | Physician Assistant | 4103 Mercantile Dr, Lake Oswego, OR 97035 | 2017-09-22 |
1891247037 | Gabrielle Engelhard | Physician Assistant | 4103 Mercantile Dr, Lake Oswego, OR 97035 | 2016-11-03 |
1982033494 | Amer J Mirza, Md PC | Clinic/Center | 4103 Mercantile Dr, Lake Oswego, OR 97035 | 2013-11-05 |
1861755126 | Craig Thomas Gillis | Orthopaedic Surgery | 4103 Mercantile Dr, Lake Oswego, OR 97035 | 2012-06-21 |
1730495599 | Monica Marie Daugherty | Physician Assistant | 4103 Mercantile Dr, Lake Oswego, OR 97035-2556 | 2010-08-30 |
1497082366 | Orthopaedic Trauma Associates | Specialist | 4103 Mercantile Dr, Lake Oswego, OR 97035 | 2009-11-12 |
1427200021 | Summit Orthopaedics, LLP | Physician Assistant | 4103 Mercantile Dr, Lake Oswego, OR 97035 | 2008-10-15 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932700127 | Teresa Siebenaler Scott | Social Worker | 3990 Sw Collins Way, Suite 202, Lake Owsego, OR 97035 | 2020-11-04 |
1528671567 | Martin Henry Lees | Internal Medicine | 14 Morningview Lane, Lake Oswego, OR 97035 | 2020-08-28 |
1356976187 | Premere Rehab LLC | Occupational Therapist | Infinity Rehab - The Springs At Lake Oswego, 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2020-03-12 |
1689212193 | Jennifer Chauvin | Nurse Practitioner | 20 Juarez Street, Lake Oswego, OR 97035 | 2019-12-16 |
1003396888 | Sarah Guenzburger | Physical Therapist | 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2018-08-21 |
1568964252 | Brett Johnson | Marriage & Family Therapist | 5655 Southwood Dr, Lake Oswego, OR 97035 | 2018-03-08 |
1912416561 | Michael Paul Long | Social Worker | 14523 Westlake Drive, Lake Oswego, Or 97035, Lake Oswego, OR 97035 | 2017-09-27 |
1467807859 | Misty Lohn | Nurse Practitioner | 5 Centerpointe Dr., Ste 600, Lake Oswego, OR 97035 | 2016-05-04 |
1326405473 | Kelsey Prince | Behavioral Analyst | 6400 Sw Rosewood St., Portland (lake Oswego), OR 97035 | 2016-01-20 |
1942683388 | Elizabeth Risberg Harrison | Massage Therapist | 190 Oswego Summit, Lake Oswego, OR 97035 | 2015-07-02 |
Find all providers in zip 97035 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
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. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134771074 | Phantom Surgical Services, LLC | Physician Assistant | 333 S State St. Suite V216, Lake Oswego, OR 97034-3948 | 2019-07-11 |
1457833394 | Cascade Pa Associates, LLC | Physician Assistant | 333 S State St Ste V # 316, Lake Oswego, OR 97034-3988 | 2018-09-06 |
1144570805 | James Herbert Moorman | Physician Assistant | 4000 Carman Dr, Unit 41, Lake Oswego, OR 97035-2475 | 2012-09-10 |
1184914608 | Kimberly Carol Fey Powers | Physician Assistant | 4823 Meadows Rd Ste 127, Lake Oswego, OR 97035-2622 | 2011-04-18 |
1457531147 | Lorena Leslie Cline | Physician Assistant | 4103 Mercantile Drive, Lake Oswego, OR 97305-6772 | 2007-11-09 |
1104016500 | Stacy R. Hampton | Physician Assistant | 16869 65th Ave # 287, Lake Oswego, OR 97035-7865 | 2007-07-31 |
1962518399 | Nancy Marie Campbell | Physician Assistant | 4035 S.w. Merchantile Drive, Suite 104, Lake Oswego, OR 97035 | 2006-08-21 |
1356850267 | Tasha Stark | Physician Assistant | 4103 Mercantile Dr, Lake Oswego, OR 97035 | 2017-09-22 |
1508201161 | Caroline Schmitz | Physician Assistant | 4015 Mercantile Dr, Suite 200, Lake Oswego, OR 97035-2552 | 2013-05-08 |
1093025918 | Julie Lyn Cramer | Physician Assistant | 5 Centerpointe Dr Ste 600, Lake Oswego, OR 97035-8662 | 2010-10-13 |
Find all providers in LAKE OSWEGO |
City | LAKE OSWEGO |
Zip Code | 97035 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.