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

Individual provider Physician Assistant · NPI 1043102825

Mr. Andrew Suryanata Mattson, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2025, 1 year ago. Practices with Orthopedic and Fracture Clinic PC, a 56-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
1
Licensed in
OR
In the registry since
2025
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

11782 SW Barnes Rd Ste 300
Portland, OR 97225-5933
Phone: (503) 214-5200
Fax: (503) 906-6613
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 14795 Sw Murray Scholls Dr, Beaverton, OR 97007-9713 — (503) 214-5200

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA227790 (OR)

Record details

NPI number1043102825
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJuly 16, 2025
Last updated in NPPESDecember 3, 2025
Certification dateDecember 3, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Orthopedic And Fracture Clinic Pc — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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