Individual provider Active NPI

Robert Paul Livingston, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bend, OR
National Provider Identifier
1275341240
Registry record updated Jan 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10019297 Issued in OR
Practice address
1128 NW Harriman St
Bend, OR 97703-1947
Phone
(541) 322-7500
Fax
(541) 322-7565
NPI assigned
Dec 23, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 10019297 OR Primary

Addresses

Primary practice location

1128 NW Harriman St
Bend, OR 97703-1947

Mailing address

2577 NE Courtney Dr
Bend, OR 97701-7752
Phone (541) 322-7500

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
I20250207002575 OR Practitioner - Nurse Practitioner 3375073125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deschutes County OregonGroup PAC ID 9638083371, 58 clinicians

Practice addresses (Care Compare)

2577 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 327-7400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10019297ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deschutes County Oregon CurrentSince Jan 27, 2025 Accepting new patients
Deschutes County Oregon Single Specialty CurrentSince Jan 27, 2025 Accepting new patients

Locations

2577 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-7400

1128 NW Harriman St
Bend, OR 97703
Phone (541) 322-7457

Interoperability endpoints

  • Direct secure messaging: rlivingston764885@direct.ochin.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736553600000",
    "number": "1275341240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017752",
            "telephone_number": "541-322-7500",
            "fax_number": "541-322-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 NW HARRIMAN ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031947",
            "telephone_number": "541-322-7500",
            "fax_number": "541-322-7565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "ROBERT",
        "middle_name": "PAUL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-23",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10019297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.