Alyssa Colleen Gormaly, RD in Portland, OR - Medicare Dietitian, Registered Provider

Alyssa Colleen Gormaly, RD is a medicare enrolled "Dietitian, Registered" provider in Portland, Oregon. Her current practice location is 2801 N Gantenbein Ave, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 413-3926.

Alyssa Colleen Gormaly is licensed to practice in Oregon (license number 10208663) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1881359792.

Contact Information

	Alyssa Colleen Gormaly, RD
	2801 N Gantenbein Ave, Portland, OR 97227-1623
	(503) 413-3926
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Alyssa Colleen Gormaly
Gender	Female
Speciality	Dietitian, Registered
Location	2801 N Gantenbein Ave, Portland, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1881359792
Provider Enumeration Date: 11/04/2021
Last Update Date: 04/11/2023

Medicare PECOS Information:

PECOS PAC ID: 1456742790
Enrollment ID: I20211222000542

Medical Identifiers

Medical identifiers for Alyssa Colleen Gormaly such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1881359792	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	10208663 (Oregon)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Alyssa Colleen Gormaly allows following entities to bill medicare on her behalf.

Provider Name	Legacy Emanuel Hospital & Health Center
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1831112358 PECOS PAC ID: 4587573639 Enrollment ID: O20040127001204

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alyssa Colleen Gormaly is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Alyssa Colleen Gormaly, RD 2801 N Gantenbein Ave, Portland, OR 97227-1623 Ph: (503) 413-3111	Alyssa Colleen Gormaly, RD 2801 N Gantenbein Ave, Portland, OR 97227-1623 Ph: (503) 413-3926

Reviews and Comments

Dietitian, Registered in Portland, OR

Kara Marie Odiaga, RD, CSR, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 703 Ne Hancock St, Portland, OR 97212 Phone: 503-493-3322 Fax: 503-287-9434
Mrs. April D Mitsch, RD Dietitian Medicare: Medicare Enrolled Practice Location: 700 Sw Campus Dr, Portland, OR 97239 Phone: 503-494-8362 Fax: 503-494-4447
Julie Marie Martin, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-5466
Alavita Perinatal Nutrition Associates, Llc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 106 Sw Woods St Ste A, Portland, OR 97201 Phone: 503-407-2549
Jennifer Christine Kainani Ching, RD Dietitian Medicare: Medicare Enrolled Practice Location: 3530 Se 88th Ave, Portland, OR 97266 Phone: 503-772-4335 Fax: 503-772-4337
Mary Ann Weinberg, RD, CNSD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-7597
Ms. Janet Lee Muckridge, RD LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3550 N Interstate Ave, Nutrition Department East Interstate, Portland, OR 97227 Phone: 503-286-6871

Alyssa Colleen Gormaly, RD - Medicare Dietitian in Portland, OR