CASSANDRA EVANETICH (PA) – Medical Physician Assistant, NPI 1093357378

CASSANDRA EVANETICH (PA) is a healthcare provider. based in Forest grove, Oregon. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA195867 (OR). The NPI Number for CASSANDRA EVANETICH (PA) is 1093357378

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
CASSANDRA EVANETICH (PA)
NPI
1093357378
Phone
(503) 359-4773
Address
1909 MOUNTAIN VIEW LN STE 200
Enumeration Date
8 October 2019
Last Update Date
4 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5033594773
Graduation Year
2019 (7 years ago)
PAC ID
8921432667
Group Practice PAC ID
1355390584
Professional Enrollment ID
I20200106000452
Address ID
OR971162894FO1909XLNXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

2,876 PHYSICIAN ASSISTANT in OR

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Provider Addresses for CASSANDRA EVANETICH (PA)

  • Mountain View Lane, Forest Grove, Metro, Washington County, Oregon, 97113-8912, United States

    FOREST GROVE, OR 971162894

    Phone: (503) 359-4773

    Fax: (503) 359-3809

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 12 Open Payments records for all available years, with a total value of $209.

Total Amount is formed as General ($209) + Research ($0) + Ownership ($0) = $209.

Last reported payment date: 2024-12-05 • Largest payer in this snapshot: Lilly USA, LLC ($43).

Total Amount

$209

General + Research + Ownership

Payments

12

Total payment records

General Amount

$209

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-05

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2020-01-06

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
I20200106000452IPhysician AssistantORTBD

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 97116)

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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: 1355390584View full group profile
NameSpecialtyState
Family PracticeOR
Physician AssistantOR
Family PracticeOR
Physician AssistantOR
Physician AssistantCA
Family PracticeOR
Mental Health CounselorTX
Nurse PractitionerOR
Physician AssistantOR
Physician AssistantOR

Reviews

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Frequently asked questions

What is CASSANDRA EVANETICH (PA)'s NPI number?
CASSANDRA EVANETICH (PA)'s NPI is 1093357378 — the number used across U.S. healthcare to identify this provider.
Is CASSANDRA EVANETICH (PA) still an active registrant?
CASSANDRA EVANETICH (PA) carries an active NPI according to the public dataset.
How would a patient describe CASSANDRA EVANETICH (PA)'s focus?
For CASSANDRA EVANETICH (PA), the primary taxonomy reads as Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with CASSANDRA EVANETICH (PA)?
Directory geography for CASSANDRA EVANETICH (PA) centers on Forest Grove, Oregon.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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