Individual provider Active NPI

Melissa Porras, CNM, NP

  • Obstetrics & Gynecology Nurse Practitioner
  • Bend, OR
National Provider Identifier
1104649474
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
201709704RN Issued in OR
Practice address
39 NW Louisiana Ave
Bend, OR 97703-3310
Phone
(415) 730-8686
NPI assigned
Nov 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 201709704RN OR Primary

Addresses

Primary practice location

39 NW Louisiana Ave
Bend, OR 97703-3310

Mailing address

1699 NW Hartford Ave
Bend, OR 97703-2453
Phone (415) 730-8686

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
I20250522003355 OR Practitioner - Nurse Practitioner 2961921838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

39 NW Louisiana Ave
Bend, OR 97703-3310
Phone (541) 330-0334

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hawthorn Healing Arts Center CurrentSince May 15, 2025 Accepting new patients

Locations

39 NW Louisiana Ave
Bend, OR 97703
Phone (541) 330-0334

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1104649474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 NW HARTFORD AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032453",
            "telephone_number": "415-730-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 NW LOUISIANA AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033310",
            "telephone_number": "415-730-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORRAS",
        "first_name": "MELISSA",
        "credential": "CNM, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "OR",
            "license": "201709704RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.