Active NPI
Andrew E Vilius, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Gresham, OR
National Provider Identifier
1003969643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 200750075NP
- Practice address
- 955 NE 3Rd St
Gresham, OR 97030-7418 - Phone
- (503) 491-5896
- NPI assigned
- Jan 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 200341326RN | OR | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 200750075NP | OR | Primary |
Addresses
Primary practice location
955 NE 3Rd St
Gresham, OR 97030-7418
Mailing address
955 NE 3Rd St
Gresham, OR 97030-7418
Phone (503) 491-5896
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2022 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200341326RN | OR | MD | Psychiatric/Mental Health Registered Nurse |
| 200750075NP | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610496000000",
"number": "1003969643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "955 NE 3RD ST",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970307418",
"telephone_number": "503-491-5896",
"fax_number": "888-972-9783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "955 NE 3RD ST",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970307418",
"telephone_number": "503-491-5896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILIUS",
"first_name": "ANDREW",
"middle_name": "E",
"credential": "PMHNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2021-01-13",
"certification_date": "2021-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "OR",
"license": "200341326RN",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "200750075NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.