ROBERT DYLAN MANGRUM (PA-C) – Surgical Physician Assistant, NPI 1871546838
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,876 PHYSICIAN ASSISTANT in OR
Provider Addresses for ROBERT DYLAN MANGRUM (PA-C)
15700 SW Greystone Ct
Beaverton, OR 970066011
Phone: (503) 494-6400
Type: Location
3303 S Bond Ave
Portland, OR 972394501
Phone: (503) 494-6400
Type: Location
Richard T. Jones Hall, 3181, Southwest Sam Jackson Park Road, Marquam Hill, Homestead, Portland, Metro, Multnomah County, Oregon, 97239, United States
PORTLAND, OR 972393011
Phone: (503) 494-8311
Type: Mailing
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: 2015-10-12
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 |
|---|---|---|---|---|
| I20151012001251 | 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 |
|---|---|---|---|---|
| 20610 | Aspiration and/or injection of fluid from large joint | 104 | 61 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 81 | 75 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 60 | 59 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 28 | 28 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 19 | 19 | $0 |
Insurance plans in this area (ZIP 97006)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | OR | 20610 | Aspiration and/or injection of large joint or joint capsule | 120 | 74 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| Diagnostic Radiology | TN | |
| - | OR | |
| Nurse Practitioner | OR | |
| - | OR | |
| - | OR | |
| General Surgery, Thoracic Surgery | WA | |
| - | OR | |
| - | OR | |
| - | WA |
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