PAIGE PATTILLO (NP) – Family Nurse Practitioner, NPI 1083091029

PAIGE PATTILLO (NP) is a healthcare provider. based in Stayton, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 201601264NP-PP (OR). The NPI Number for PAIGE PATTILLO (NP) is 1083091029

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
PAIGE PATTILLO (NP)
NPI
1083091029
Phone
(503) 507-5356
Address
PO BOX 118
Enumeration Date
29 April 2015
Last Update Date
27 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5035075356
Graduation Year
2014 (12 years ago)
PAC ID
4587961917
Group Practice PAC ID
1456614361
Professional Enrollment ID
I20160329002424
Address ID
OR973839739ST41805SEXX500
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness85
Years active:11State licenses:2Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for PAIGE PATTILLO (NP)

  • PO BOX 118

    STAYTON, OR 973830118

    Phone: (503) 507-5356

    Fax: (866) 225-2708

    Type: Mailing

  • 1625 CAMP BAKER RD

    MEDFORD, OR 975019605

    Phone: (541) 841-6132

    Type: Mailing

  • 9900 BREN RD E

    MINNETONKA, MN 553439664

    Phone: (205) 936-1386

    Type: Location

  • 9900 Bren Rd E

    Minnetonka, MN 553439664

    Phone: (205) 936-1386

    Type: Location

  • 41805 STAYTON SCIO RD SE

    STAYTON, OR 973839739

    Phone: (503) 507-5356

    Fax: (866) 225-2708

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-03-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160329002424INurse PractitionerORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97383)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1456614361View full group profile
NameSpecialtyState
Nurse PractitionerOR
Nurse PractitionerOR
Nurse PractitionerOR
Nurse PractitionerOR

Reviews

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Frequently asked questions

What federal number belongs to PAIGE PATTILLO (NP)?
The federal identifier for PAIGE PATTILLO (NP) is NPI 1083091029.
Does this profile mean PAIGE PATTILLO (NP) is currently active?
Yes — PAIGE PATTILLO (NP) appears active in the national provider directory.
Does PAIGE PATTILLO (NP) list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for PAIGE PATTILLO (NP). Clinical services aligned with this taxonomy classification.
Where is PAIGE PATTILLO (NP)'s primary listing?
We display Stayton, Oregon because that is what the record indicates for PAIGE PATTILLO (NP).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.