JARED MIRACLE (PA-C) – Physician Assistant, NPI 1205726569

JARED MIRACLE (PA-C) is a healthcare provider. based in Beaverton, Oregon. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. The NPI Number for JARED MIRACLE (PA-C) is 1205726569

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
JARED MIRACLE (PA-C)
NPI
1205726569
Phone
(503) 430-1777
Address
6800 SW 105TH AVE
Enumeration Date
8 July 2025
Last Update Date
3 May 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8552551750
Graduation Year
2025 (1 year ago)
PAC ID
1254839673
Group Practice PAC ID
2860794070
Professional Enrollment ID
I20250813003282
Address ID
OR972204449PO9750XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience15
Completeness85
Years active:0State licenses:0Digital endpointsOther names

2,876 PHYSICIAN ASSISTANT in OR

Provider Addresses for JARED MIRACLE (PA-C)

  • 6800 SW 105TH AVE

    BEAVERTON, OR 970085468

    Phone: (503) 430-1777

    Type: Mailing

  • PO BOX 24081

    SEATTLE, WA 981240081

    Phone: (855) 255-1750

    Fax: (855) 255-0905

    Type: Mailing

  • 5200 MEADOWS RD STE 200

    LAKE OSWEGO, OR 970350086

    Phone: (855) 255-1750

    Fax: (855) 255-0905

    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: 2025-08-13

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
I20250813003282IPhysician 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 97008)

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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: 2860794070View full group profile
NameSpecialtyState
Nurse PractitionerID
Physician AssistantWA
Physician AssistantID
Nurse PractitionerOR
Physician AssistantAZ
-CA
-UT
Physician AssistantID
Physician AssistantOR
-CA

Reviews

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Frequently asked questions

How is JARED MIRACLE (PA-C) identified in CMS data?
CMS-hosted NPPES data lists JARED MIRACLE (PA-C) with NPI 1205726569.
Can I rely on JARED MIRACLE (PA-C) being an active provider?
As of the registry snapshot, JARED MIRACLE (PA-C) is marked active.
What is JARED MIRACLE (PA-C) best known for clinically?
Directory data describes JARED MIRACLE (PA-C) with Physician Assistant. Clinical services aligned with this taxonomy classification.
Where should I expect JARED MIRACLE (PA-C) on a map?
Expect Beaverton, Oregon as a primary anchor for JARED MIRACLE (PA-C) unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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