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

Individual provider Physician Assistant · NPI 1831867761

Nicholas Robert Grzenda, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2021, 5 years ago. Practices with Legacy Clinics LLC, a 718-clinician group and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2021
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

340 NE 100th Ave Apt J
Portland, OR 97220-4430
Phone: (720) 560-8648
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1831867761
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 3, 2021
Last updated in NPPESSeptember 3, 2021
Certification dateSeptember 3, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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