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

Individual provider Physician Assistant · NPI 1588493050

Nicole Kelly, PA-C is a Physician Assistant in Portland, Oregon. Graduated from Baylor College of Medicine in 2023, 3 years ago. Practices with University Professional Services, a 1,704-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
3
Trained at
Baylor College of Medicine
Licensed in
OR
In the registry since
2024
Specialties on file
2
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

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-4314
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA220357 (OR)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1588493050
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 31, 2024
Last updated in NPPESOctober 8, 2024
Certification dateOctober 8, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolBAYLOR COLLEGE OF MEDICINE
Graduated 2023 (3 years in practice)
Group practice University Professional Services — 1704 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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