Elisabeth Ruth Decelles, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Salem, OR
NPI 1114435807 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1114435807
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 201902988NP-PP (OR)
- Practice address
- 1233 Edgewater St NW
Salem, OR 97304-4049 - Phone
- (503) 378-7526
- NPI assigned
- Jan 16, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of South Alabama College of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northwest Human Services Inc
Practice addresses (Care Compare)
1233 Edgewater St NW
Salem, OR 97304-4049
Phone (503) 378-7526
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190819003089 | OR | Practitioner - Nurse Practitioner | 0345501029 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Human Services, Inc. | Current |
Accepting new patients | |
| Northwest Human Services, Inc. | Current |
Accepting new patients |
Locations
180 Atwater St N
Monmouth, OR 97361
Phone (503) 378-7526
1233 Edgewater St NW
Ste B
Salem, OR 97304
Phone (503) 378-7526
1233 Edgewater St NW
Salem, OR 97304
Phone (503) 378-7526
Interoperability endpoints
- elisabeth.decelles.p1@direct.nwhumanservices.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP10900 | AZ | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 201902988NP-PP | OR | Yes |
Addresses
Primary practice location
1233 Edgewater St NW
Salem, OR 97304-4049
Mailing address
2550 E Show Low Lake Rd BLDG B
Show Low, AZ 85901-7929
Phone (928) 537-2951
Other practice location 1
2550 E Show Low Lake Rd Bldg B
Show Low, AZ 85901-7929
Phone (928) 537-2951
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | elisabeth.decelles.p1@direct.nwhumanservices.nextgenshare.com | Direct | Northwest Human Services, Inc. |
Other providers in Salem, OR
- Deborah M Johnson MD PC
- Xan K Decambra
- Lindsey Decampos-Stairiker
- Catherine Elaine Decampos
- Melissa Decarlo
- Jordan Marissa Decker
- Cynthia Vermillion Deckert
- Dedicated Hearts in-Home Care LLC
- Kathryn Marie Deeds
- Deep Currents Trauma Therapy
All providers in Salem, OR · Psychiatric/Mental Health Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.