Individual provider Active NPI

Andrene Benjamin, PMHNP, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1164074456
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10031837 Issued in OR
Practice address
310 SW 4TH Ave Unit 3-H
Portland, OR 97204-2345
Phone
(503) 647-6501
Fax
(503) 388-7702
NPI assigned
Jul 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10031837 OR Primary
Family Nurse Practitioner 363LF0000X NP95011901 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61632738 WA

Addresses

Primary practice location

310 SW 4TH Ave Unit 3-H
Portland, OR 97204-2345

Mailing address

306 Lincoln Rd
Miami Beach, FL 33139-3103

Other practice location 1

1220 Main St Ste 455
Vancouver, WA 98660-2963
Phone (503) 647-6501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241121000324 FL Practitioner - Nurse Practitioner 4486189917 Practice locations: Pembroke Pines, FL
I20250411002302 OR Practitioner - Nurse Practitioner 4486189917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sondermind PAGroup PAC ID 3577099621, 78 clinicians

Practice addresses (Care Compare)

Portland, OR 97223
Phone (866) 630-0966

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95011901CAMDFamily Nurse Practitioner
AP61632738WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind, P.a. Psychiatric/Mental Health CurrentSince Apr 2, 2025 Accepting new patients
Transcend Mind-Body Wellness, LLC Psychiatric/Mental Health Past Accepting new patients
Mindrx, LLC Past Accepting new patients

Locations

10260 SW Greenburg Rd
Fl 4
Tigard, OR 97223
Phone (503) 405-9338

Organizations & group practices 3

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": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1164074456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 LINCOLN RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331393103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 SW 4TH AVE UNIT 3-H",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042345",
            "telephone_number": "503-647-6501",
            "fax_number": "503-388-7702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 Main St Ste 455",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986602963",
            "country_code": "US",
            "telephone_number": "503-647-6501",
            "fax_number": "503-388-7702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "ANDRENE",
        "credential": "PMHNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10031837",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95011901",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61632738",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.