Individual provider Active NPI

Florence L Trentacosti, PSYD

  • Psychologist
  • Portland, OR
National Provider Identifier
1073533915
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1406 Issued in OR
Practice address
1880 SW Huntington Ave
Portland, OR 97225-4754
Phone
(563) 641-6674
Fax
(503) 641-6674
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1406 OR Primary
Clinical Psychologist 103TC0700X 1406 OR

Addresses

Primary practice location

1880 SW Huntington Ave
Portland, OR 97225-4754

Mailing address

1880 SW Huntington Ave
Portland, OR 97225-4754
Phone (563) 641-6674

Other identifiers 2

IdentifierTypeStateIssuer
116035OtherMANAGED HEALTH NETWORK
005440000OtherREGENCE BCBS

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100218000782 OR Practitioner - Clinical Psychologist 6608910310 Practice locations: Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1880 SW Huntington Ave
Portland, OR 97225-4754
Phone (503) 641-6674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1406ORMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1073533915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 SW HUNTINGTON AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972254754",
            "telephone_number": "563-641-6674",
            "fax_number": "503-641-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 SW HUNTINGTON AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972254754",
            "telephone_number": "563-641-6674",
            "fax_number": "503-641-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENTACOSTI",
        "first_name": "FLORENCE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "1406",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1406",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "116035",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BCBS",
            "identifier": "005440000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.