TARA PEMBERTON (PA-C) – Medical Physician Assistant, NPI 1275803462
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,876 PHYSICIAN ASSISTANT in OR
Provider Addresses for TARA PEMBERTON (PA-C)
9495 SW LOCUST ST
SUITE A & E
PORTLAND, OR 972236683
Phone: (503) 505-5937
Fax: (503) 505-5922
Type: Location
9495SWLOCUST ST A
PORTLAND, OR 972236683
Phone: (503) 636-9011
Fax: (503) 636-3952
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 36 Open Payments records for all available years, with a total value of $867.
Total Amount is formed as General ($867) + Research ($0) + Ownership ($0) = $867.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: GENZYME CORPORATION ($162).
Total Amount
$867
General + Research + Ownership
Payments
36
Total payment records
General Amount
$867
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GENZYME CORPORATION | $162 |
| Regeneron Healthcare Solutions, Inc. | $148 |
| CSL Behring | $140 |
| ABBVIE INC. | $109 |
| GlaxoSmithKline, LLC. | $59 |
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: 2012-06-11
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120611000306 | I | Physician Assistant | OR | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 96372 | Injection of drug or substance under skin or into muscle | 44 | 11 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 42 | 13 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 24 | 23 | $0 |
Insurance plans in this area (ZIP 97223)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| - | OR | |
| Physician Assistant | OR | |
| A L L E R G Y/ I M M U N O L O G Y | OR | |
| - | OR | |
| - | WA | |
| - | OR | |
| A L L E R G Y/ I M M U N O L O G Y | OR |
Reviews
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