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Active NPI 1821653254 Individual Practitioner Female Practitioner

Kamylli J Mendive , PA-C

Physician Assistant • Tigard, OR

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Kamylli Mendive, PA-C is a certified Physician Assistant practicing in Tigard, OR. With approximately 6 years of clinical experience since graduating from Oregon Health Sciences University School Of Medicine in 2020, Kamylli Mendive delivers high-quality medical care to the local community at 12442 SW SCHOLLS FERRY RD STE 100.

Kamylli Mendive is affiliated with Providence Health And Services Oregon and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

12442 Sw Scholls Ferry Rd Ste 100

Tigard, OR 972230803

Telephone 5032169200
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Oregon Health Sciences University School Of Medicine

Graduation Year

2020

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Tigard, OR

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs -5.3 yrs vs City Avg
City Avg: 11.3 Yrs
State Avg: 10.5 Yrs
Regional Practice Density
50 Specialists

Practicing in Tigard, OR (2106 Statewide)

Telehealth Adoption Rate
26.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
63.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mendive (6 Years) 6 Yrs
Tigard Specialty Average (11.3 Years) 11.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
69 61 $373.84 $120.50
99213 Established patient office or other outpatient visit, typically 15 minutes
23 22 $201.78 $90.64

Medical Specialties & State Licenses

CMS Verified: 2024-09-30
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License OR PA202793

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.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License CA 58813

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.

Hospital & Practice Group Affiliations

Providence Health And Services Oregon

12442 Sw Scholls Ferry Rd, Tigard, OR 972230803

Phone: 5032159900

Providence Health And Services Oregon

5050 Ne Hoyt St, Portland, OR 972132981

Phone: 5032156480

Practice Associates & Co-Workers

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

30 Associated Practitioners
Dr. Evagelia Baros , DO

Internal Medicine

NPI 1003019340

Doctor of Osteopathic Medicine (D.O.)

NPI 1043246689

Doctor of Medicine (M.D.)

Dr. Marina Wagner , DO

Family Medicine

NPI 1073190773

Doctor of Osteopathic Medicine (D.O.)

NPI 1144250085

Doctor of Medicine (M.D.)

Martha Geisheker , ANP

Nurse Practitioner - Adult Health

NPI 1194800961

Adult Nurse Practitioner

Dr. Aileen Kim , MD

Internal Medicine

NPI 1255360657

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

12 Historical Events
📍
Updated Practice Location September 30, 2024

Registered at 12442 SW SCHOLLS FERRY RD STE 100, TIGARD, OR 972230803 (Tel: 5032169200)

📍
Updated Business Mailing Address September 30, 2024

Registered at PO BOX 3158, PORTLAND, OR 972083158 (Tel: 5032156494)

📍
Updated Practice Location January 11, 2021

Registered at 2415 HIGH SCHOOL AVE STE 800, CONCORD, CA 945201858 (Tel: 9256875210)

📍
Updated Business Mailing Address January 11, 2021

Registered at 2415 HIGH SCHOOL AVE STE 800, CONCORD, CA 945201858 (Tel: 9256875210)

👤
Provider Name / Credentials Updated January 11, 2021

Recorded as KAMYLLI MENDIVE, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 11, 2021

Physician Assistant (License #58813 in CA)

NPI Profile Active May 01, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location May 01, 2019

Registered at 2730 SW MOODY AVE, PORTLAND, OR 972015042 (Tel: 5034943633)

📍
Updated Business Mailing Address May 01, 2019

Registered at 2730 SW MOODY AVE, PORTLAND, OR 972015042 (Tel: 5034943633)

👤
Provider Name / Credentials Updated May 01, 2019

Recorded as KAMYLLI MENDIVE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 01, 2019

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 01, 2019

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: 1821653254
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 01, 2019
Last Update: September 30, 2024
Sole Proprietor: No

Mailing Address

Po Box 3158

Portland, OR 972083158

Phone: 5032156494

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.