Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lucy Nusrala, PA-C

Individual provider Physician Assistant · NPI 1821087891

Lucy Nusrala, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2004, 22 years ago. Practices with Broadway Medical Clinic LLP, an 18-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
22
Licensed in
OR
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4212 NE Broadway
Portland, OR 97213-1422
Phone: (503) 249-8787
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA01448 (OR)

Record details

NPI number1821087891
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 20, 2005
Last updated in NPPESJune 9, 2026
Certification dateJune 9, 2026
Mailing address541 Ne 20th Ave Ste 225, Portland, OR 97232-2895

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Broadway Medical Clinic Llp — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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