Individual provider Active NPI

Kirsten Lynne Roberts, F.N.P.

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1003864596
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
094006664N1 Issued in OR
Practice address
5050 NE Hoyt St Ste 117
Portland, OR 97213
Phone
(503) 215-1874
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services Oregon 1,423 clinicians

Practice addresses (Care Compare)

4805 NE Glisan St
Portland, OR 97213-2933

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

Hospital & facility affiliations

  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
  • Providence Hood River Memorial Hospital Hospital, Hood River, OR, CCN 381318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041004000652 OR Practitioner - Nurse Practitioner 8224097571 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
094006664N1ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Oct 12, 2022 Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 12, 2022 Accepting new patients
Multnomah County Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Multnomah County CurrentSince Apr 22, 2010 Accepting new patients
Multnomah County CurrentSince Apr 22, 2010 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2022 Accepting new patients
Providence Health & Services - Oregon CurrentSince May 1, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince May 1, 2019 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

4805 NE Glisan St
Ste 3E14
Portland, OR 97213

5050 NE Hoyt St
Ste 117
Portland, OR 97213
Phone (503) 215-1874

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Interoperability endpoints

  • Direct secure messaging: kroberts1030677@oc.providencedirect.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 094006664N1 OR Primary

Addresses

NPPES NPI Registry

Primary practice location

5050 NE Hoyt St Ste 117
Portland, OR 97213

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other practice location 1

421 SW Oak St.
#210
Portland, OR 97204
Phone (503) 988-7468

Other practice location 2

421 SW Oak St.
#210
Portland, OR 97204
Phone (503) 988-7468

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
228493MedicaidOR

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address kroberts1030677@oc.providencedirect.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 2, 2020.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1003864596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST STE 117",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97213",
            "telephone_number": "503-215-1874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 SW Oak St.",
            "address_2": "#210",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97204",
            "country_code": "US",
            "telephone_number": "503-988-7468",
            "fax_number": "503-988-3015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "421 SW Oak St.",
            "address_2": "#210",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97204",
            "country_code": "US",
            "telephone_number": "503-988-7468",
            "fax_number": "503-988-3015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KIRSTEN",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "094006664N1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228493",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kroberts1030677@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St Ste 117",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.