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JENNIFER BOTELHO PA-C NPI 1891782751


NPI Information

NPI: 1891782751
Provider Name: JENNIFER BOTELHO, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Organization: NORTHWEST UROLOGY LLC

PECOS Registration: Yes

Address:
1130 NW 22ND AVE STE 535
PORTLAND, OR
ZIP 97210
Phone: (503) 274-4999
Get Directions

Jennifer Botelho, PA-C is a surgical physician assistant in Portland, OR with 22 years of experience. Jennifer Botelho, PA-C NPI is 1891782751. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1130 NW 22ND AVE STE 535
PORTLAND, OR
ZIP 97210-976
Phone: (503) 274-4999

The NPI 1891782751 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/5/2005 and was last updated on 8/26/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363AS0400XPhysician AssistantSurgicalPA00838OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1191806OTHEROREGONDOLI
2118153MEDICARE ID-TYPE UNSPECIFIEDOREGON
38404378MEDICAIDWASHINGTON
4PA00838MEDICAIDOREGON
5P73533MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.