JEFFREY ALLAN KOLLER (PA-C) – Physician Assistant, NPI 1215790639

JEFFREY ALLAN KOLLER (PA-C) is a healthcare provider. based in Sublimity, Oregon. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA218511 (OR). The NPI Number for JEFFREY ALLAN KOLLER (PA-C) is 1215790639

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
JEFFREY ALLAN KOLLER (PA-C)
NPI
1215790639
Phone
(503) 769-2259
Address
114 SE CHURCH ST
Enumeration Date
31 January 2024
Last Update Date
22 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2023 (3 years ago)
PAC ID
0749629681
Group Practice PAC ID
6103729751
Professional Enrollment ID
I20240411003577
Address ID
OR973831311St1401XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

2,876 PHYSICIAN ASSISTANT in OR

Provider Addresses for JEFFREY ALLAN KOLLER (PA-C)

  • 114 SE CHURCH ST

    SUBLIMITY, OR 973859424

    Phone: (503) 769-2259

    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)

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: 2024-04-11

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
I20240411003577IPhysician 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 97385)

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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: 6103729751View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TN
Emergency MedicineOR
Physician AssistantOR
Physician AssistantOR
Physician AssistantOR
Emergency MedicineOR
-OR
Nurse PractitionerOR
Certified Registered Nurse Anesthetist (Crna)OR
Physician AssistantOR

Reviews

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Frequently asked questions

What unique ID ties claims to JEFFREY ALLAN KOLLER (PA-C)?
NPI 1215790639 is assigned to JEFFREY ALLAN KOLLER (PA-C) under the national enumeration system.
Is JEFFREY ALLAN KOLLER (PA-C) currently active in the NPI registry?
CMS-published data lists JEFFREY ALLAN KOLLER (PA-C) as an active registrant.
What does JEFFREY ALLAN KOLLER (PA-C) treat or focus on?
Patients typically see JEFFREY ALLAN KOLLER (PA-C) under the specialty Physician Assistant. Clinical services aligned with this taxonomy classification.
What location metadata exists for JEFFREY ALLAN KOLLER (PA-C)?
The page summarizes Sublimity, Oregon for JEFFREY ALLAN KOLLER (PA-C); expand the address list for detail.
How can I contact JEFFREY ALLAN KOLLER (PA-C)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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