Individual provider Active NPI

Robert Kabuti Maina

  • Psychiatric/Mental Health Nurse Practitioner
  • Tigard, OR
National Provider Identifier
1164297933
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10021039 Issued in OR
Practice address
14322 SW Woodhue St
Tigard, OR 97224-0965
Phone
(469) 531-5568
NPI assigned
Nov 21, 2023
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0809X 809248 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10021039 OR Primary

Addresses

Primary practice location

14322 SW Woodhue St
Tigard, OR 97224-0965

Mailing address

21155 E Duncan St
Queen Creek, AZ 85142-6763

Other practice location 1

412 E Southern Ave
Tempe, AZ 85282-5212
Phone (469) 531-5568

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
I20250416003482 OR Practitioner - Nurse Practitioner 2264957737 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
809248TXMDAdult Psychiatric/Mental Health Registered Nurse
10021039ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirant Health LLC Current Accepting new patients
Aspirant Wellness Solutions LLC Single Specialty CurrentSince Apr 1, 2025 Accepting new patients

Locations

4304 SE 182nd Ave
Gresham, OR 97030
Phone (469) 396-5980

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1164297933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21155 E DUNCAN ST",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14322 SW WOODHUE ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972240965",
            "telephone_number": "469-531-5568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 E Southern Ave",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852825212",
            "country_code": "US",
            "telephone_number": "469-531-5568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAINA",
        "first_name": "ROBERT",
        "middle_name": "KABUTI",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-21",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "TX",
            "license": "809248",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10021039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.