Katherine Felicia Edstrom, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

201905490NP-PP Issued in OR

Practice address

5100 S Macadam Ave Ste 200
Portland, OR 97239-3827

Phone

(971) 202-5500

Fax

(971) 202-5555

NPI assigned

Jul 15, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

University of Washington School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Housecall Providers PCGroup PAC ID 7113297789, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Care Home health agency, Portland, OR, CCN 387003
• Divine Mercy Home Health, LLC Home health agency, Beaverton, OR, CCN 387164
• Connected Home Health Home health agency, Clackamas, OR, CCN 387146
• Adventist Health Portland Hospital, Portland, OR, CCN 380060

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katherineedstrom@hpi.allscriptsdirect.net

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.

• Housecall Providers, PC

  • Geriatric Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1396274817
  Medicare reassignment Care Compare group NPD
• Housecall Providers Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1619915774
  NPD

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

• Amedisys Oregon, L.L.C.

  • Home Health Agency
  • Portland, OR
  • NPI 1134311988
  Care Compare affiliation
• Connected Healthcare, Inc.

  • Home Health Agency
  • Clackamas, OR
  • NPI 1063780492
  Care Compare affiliation
• Divine Mercy Home Health, LLC.

  • Home Health Agency
  • Beaverton, OR
  • NPI 1932556750
  Care Compare affiliation
• Portland Adventist Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1801887658
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1043862550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8562",
            "fax_number": "503-418-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 S MACADAM AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393827",
            "telephone_number": "971-202-5500",
            "fax_number": "971-202-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-8562",
            "fax_number": "503-418-5505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDSTROM",
        "first_name": "KATHERINE",
        "middle_name": "FELICIA",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "201905490NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edna Kung, MD, PC
• Megan T Ednoff, RN
• Edsel U. Kim, M.D. LLC
• Lysanji Edson, N.D.
• Tifanie Edson
• Eduardo C. Lopez, D.D.S., PC
• Kela Edvalson, RPH
• Donald Howard Edwall, PA
• Edward S Phinney Jr, MD, PC
• Edwards Psychotherapy, P.C.

• Gerontology Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Gerontology Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.