Organization Active NPI

Oceanic Health Group LLC

  • Psychiatry Physician
  • Beaverton, OR
National Provider Identifier
1275362451
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
OCEANIC HEALTH GROUP LLC
Practice address
1500 NW Bethany Blvd Ste 200
Beaverton, OR 97006-5236
Phone
(612) 423-3606
NPI assigned
Jul 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Paul Nyabero Obino, PMHNP-BCNPI 1619757820
Title
Founder
Phone
(612) 423-3606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1500 NW Bethany Blvd Ste 200
Beaverton, OR 97006-5236

Mailing address

1500 NW Bethany Blvd Ste 200
Beaverton, OR 97006-5236
Phone (612) 423-3606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240926000652 OR Part B Supplier - Clinic/Group Practice 4789125014 Receives reassigned benefits from 1 practitioner
Practice locations: Beaverton, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1275362451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 NW BETHANY BLVD STE 200",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065236",
            "telephone_number": "612-423-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 NW BETHANY BLVD STE 200",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065236",
            "telephone_number": "612-423-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEANIC HEALTH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-28",
        "status": "A",
        "authorized_official_last_name": "OBINO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "NYABERO",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "612-423-3606",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.