NPIMap

Individual provider Active NPI

Ellerey Claire Nelson, NURSE PRACTITIONER

  • Nurse Practitioner
  • Portland, OR
National Provider Identifier
1073185815
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
202106760NP-PP Issued in OR
Practice address
10000 SE Main St Ste 60
Portland, OR 97216-2474
Phone
(503) 257-0959
NPI assigned
Jul 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 202106760NP-PP OR Primary

Addresses

Primary practice location

10000 SE Main St Ste 60
Portland, OR 97216-2474

Mailing address

1930 NW Irving St Apt 301
Portland, OR 97209-1266
Phone (503) 913-3727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210917001560 OR Practitioner - Nurse Practitioner 1355748377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland Adventist Medical CenterGroup PAC ID 3274908819, 273 clinicians

Practice addresses (Care Compare)

10000 SE Main St
Suite 60
Portland, OR 97216-2474
Phone (503) 257-0959

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Adventist Medical Center CurrentSince Jul 7, 2023 Accepting new patients
Portland Adventist Medical Center CurrentSince Jul 7, 2023 Accepting new patients
Portland Adventist Medical Center CurrentSince Sep 30, 2021 Accepting new patients
Portland Adventist Medical Center CurrentSince Sep 30, 2021 Accepting new patients

Locations

10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880

14450 SE Royer Rd
Damascus, OR 97089
Phone (503) 658-5521

10000 SE Main St
Ste 60A
Portland, OR 97216
Phone (503) 257-0959

10000 SE Main St
Ste 60
Portland, OR 97216
Phone (503) 257-0959

Interoperability endpoints

  • Direct secure messaging: enelson154681@direct.ohsu.edu

Organizations & group practices 4

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

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1073185815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 NW IRVING ST APT 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091266",
            "telephone_number": "503-913-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST STE 60",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162474",
            "telephone_number": "503-257-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ELLEREY",
        "middle_name": "CLAIRE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202106760NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.