Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1710591821 Individual Practitioner Male Practitioner

Soohan Bong

Physician Assistant • Portland, OR

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Soohan Bong is a certified Physician Assistant practicing in Portland, OR. With approximately 5 years of clinical experience since completing medical education in 2021, Soohan Bong delivers high-quality medical care to the local community at 5050 NE HOYT ST STE 359.

Soohan Bong is affiliated with The Oregon Clinic, Pc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include fusion of additional segment of spine, partial removal of middle spine bone with release of spinal cord and/or nerves, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

5050 Ne Hoyt St Ste 359

Portland, OR 972132983

Telephone 5039358501
Fax 5039358506

Medicare Profile & Education

Medical School

Other

Graduation Year

2021

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Portland, OR

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
5 Yrs -5.1 yrs vs City Avg
City Avg: 10.1 Yrs
State Avg: 10.5 Yrs
Regional Practice Density
470 Specialists

Practicing in Portland, OR (2106 Statewide)

Telehealth Adoption Rate
23.8% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
78.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Bong (5 Years) 5 Yrs
Portland Specialty Average (10.1 Years) 10.1 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
22614 Fusion of additional segment of spine
32 12 $238.71 $50.93
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves
20 20 $711.00 $115.85
99213 Established patient office or other outpatient visit, typically 15 minutes
14 14 $314.00 $79.24
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more
13 13 $761.00 $190.71
22612 Fusion of spine in lower back
12 12 $1007.45 $212.63

Medical Specialties & State Licenses

CMS Verified: 2021-10-12
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License OR PA207120

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
500813996 (OR)

Hospital & Practice Group Affiliations

The Oregon Clinic, Pc

5050 Ne Hoyt St, Portland, OR 972132983

The Oregon Clinic, Pc

1111 Ne 99th Ave, Portland, OR 972209442

The Oregon Clinic, Pc

5050 Ne Hoyt, Portland, OR 972132990

Phone: 5032396673

The Oregon Clinic, Pc

4805 Ne Glisan, Portland, OR 972132933

Secondary Practice Locations

9155 Sw Barnes Rd Ste 440

Portland, OR 972256631

Phone: 5039358500

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Dr. David Antezana , MD

Neurological Surgery

NPI 1225024052

Doctor of Medicine (M.D.)

Dr. Michelle Williams , MD

Neurological Surgery

NPI 1407218472

Doctor of Medicine (M.D.)

Callum Mackintosh

Physician Assistant - Surgical

NPI 1902427776
Megan Kennedy , NP

Nurse Practitioner - Acute Care

NPI 1902436389

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location February 07, 2023

Registered at 5050 NE HOYT ST STE 359, PORTLAND, OR 972132983 (Tel: 5039358501)

📍
Updated Business Mailing Address February 07, 2023

Registered at 847 NE 19TH AVE STE 300, PORTLAND, OR 972322686 (Tel: 5039632801)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 07, 2023

Student in an Organized Health Care Education/Training Program

👤
Provider Name / Credentials Updated September 16, 2021

Recorded as SOOHAN BONG

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 16, 2021

Physician Assistant

NPI Profile Active September 04, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location September 04, 2020

Registered at 222 SE 8TH AVE, HILLSBORO, OR 971234218 (Tel: 5033523628)

📍
Updated Business Mailing Address September 04, 2020

Registered at 718 20TH AVE, HONOLULU, HI 968164564 (Tel: 8082531458)

👤
Provider Name / Credentials Updated September 04, 2020

Recorded as SOO HAN BONG

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 04, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration September 04, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710591821
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 04, 2020
Last Update: February 07, 2023
Sole Proprietor: No

Mailing Address

847 Ne 19th Ave Ste 300

Portland, OR 972322686

Phone: 5039632801

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.