Individual provider Active NPI

Debdeep Nath, N.P.

  • Pediatric Nurse Practitioner
  • Portland, OR
National Provider Identifier
1164829578
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
201606039NP-PP Issued in OR
Practice address
10260 SW Greenburg Rd FL 4
Portland, OR 97223-5500
Phone
(971) 334-1381
Fax
(503) 300-5388
NPI assigned
Dec 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 201606039NP-PP OR Primary

Addresses

Primary practice location

10260 SW Greenburg Rd FL 4
Portland, OR 97223-5500

Mailing address

10260 SW Greenburg Rd FL 4
Portland, OR 97223-5500
Phone (971) 334-1381

Other practice location 1

8770 SW Scoffins St
Tigard, OR 97223-6226
Phone (503) 684-1424

Other practice location 2

1308 NW 20th Ave Ste 12
Portland, OR 97209-1607
Phone (971) 334-1381

Other practice location 3

10300 SW Greenburg Rd Ste 240
Portland, OR 97223-5414
Phone (503) 206-6285

Other practice location 4

1308 NW 20th Ave Ste 12
Portland, OR 97209-1607
Phone (971) 334-1381

Other practice location 5

12225 SW 2nd St Ste 150
Beaverton, OR 97005
Phone (971) 334-1381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201606039NP-PPORMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Counseling Collective LLC PastSince Mar 1, 2021 Accepting new patients

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": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1164829578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10260 SW GREENBURG RD FL 4",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235500",
            "telephone_number": "971-334-1381",
            "fax_number": "503-300-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10260 SW GREENBURG RD FL 4",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235500",
            "telephone_number": "971-334-1381",
            "fax_number": "503-300-5388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8770 SW Scoffins St",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972236226",
            "country_code": "US",
            "telephone_number": "503-684-1424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1308 NW 20th Ave Ste 12",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972091607",
            "country_code": "US",
            "telephone_number": "971-334-1381",
            "fax_number": "503-296-2102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10300 SW Greenburg Rd Ste 240",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972235414",
            "country_code": "US",
            "telephone_number": "503-206-6285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1308 NW 20th Ave Ste 12",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972091607",
            "country_code": "US",
            "telephone_number": "971-334-1381",
            "fax_number": "503-296-2102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12225 SW 2nd St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "97005",
            "country_code": "US",
            "telephone_number": "971-334-1381",
            "fax_number": "503-300-5388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NATH",
        "first_name": "DEBDEEP",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-01",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "201606039NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.