Individual provider Active NPI

Karina Marie Squire, DNP

  • Family Nurse Practitioner
  • Seaside, OR
National Provider Identifier
1154772911
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201604168NP-PP Issued in OR
Practice address
725 S Wahanna Rd
Seaside, OR 97138-7735
Phone
(503) 717-7060
NPI assigned
Jun 23, 2016
Last updated
Nov 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201604168NP-PP OR Primary

Addresses

Primary practice location

725 S Wahanna Rd
Seaside, OR 97138-7735

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other identifiers 1

IdentifierTypeStateIssuer
500712033MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ksquire668768@oc.providencedirect.org
Direct Messaging Address ksquire668768@oc.providencedirect.org

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
I20160816001213 OR Practitioner - Nurse Practitioner 2769776632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Minnesota Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

417 SW 117TH Ave
Suite 200
Portland, OR 97225-5924
Phone (503) 216-1800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
201604168NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 1, 2021 Accepting new patients
Providence Health & Services Oregon CurrentSince Oct 1, 2021 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

417 SW 117th Ave
Ste 200
Portland, OR 97225
Phone (503) 216-1800

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Interoperability endpoints

  • Direct secure messaging: ksquire668768@oc.providencedirect.org

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 3

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": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1154772911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S WAHANNA RD",
            "city": "SEASIDE",
            "state": "OR",
            "postal_code": "971387735",
            "telephone_number": "503-717-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRE",
        "first_name": "KARINA",
        "middle_name": "MARIE",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201604168NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500712033",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksquire668768@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "171 N Larch St Ste 16",
            "city": "Cannon Beach",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971103103",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksquire668768@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "417 SW 117th Ave Ste 200",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972255924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seaside, OR

Sources for this page

Verify at the official NPI Registry.