Ryan T Tartaglia, PA-C
Physician Assistant, Medical in Portland, OR. Individual provider (NPI-1).
NPI number1265995658
StatusActive
Last updated in NPPESJan 24, 2023
Details
- NPI
- 1265995658
- Entity type
- Individual (NPI-1)
- Name
- Ryan T Tartaglia
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 11, 2019
- Certification date
- Jan 24, 2023
- Last updated
- Jan 24, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA10012 | OR | Yes |
| 363A00000X | Physician Assistant | – | – |
Practice location
3181 Sw Sam Jackson Park RdPortland, OR 97239-3011
Phone 503-494-6594 · Fax 503-494-4285
Mailing address
3181 Sw Sam Jackson Park RdPortland, OR 97239-3011
Phone 503-494-6594 · Fax 503-494-4285
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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