Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Leland Matthew Piccolo, PAC

Individual provider Physician Assistant · NPI 1114116993

Mr. Leland Matthew Piccolo, PAC is a Physician Assistant in Portland, Oregon. Qualified in 2008, 18 years ago. Practices with Kaiser Foundation Health Plan of the Northwest, a 1,811-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
18
Licensed in
OR
In the registry since
2007
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

9155 SW Barnes Rd Ste 440
Portland, OR 97225-6625
Phone: (503) 297-3766
Fax: (503) 297-8148
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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 PA01395 (OR)

Record details

NPI number1114116993
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedOctober 17, 2007
Last updated in NPPESMarch 7, 2022
Certification dateMarch 7, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Kaiser Foundation Health Plan Of The Northwest — 1811 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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