Individual provider Active NPI

Louise Ellen Marasco, PH.D.

  • Clinical Psychologist
  • Portland, OR
National Provider Identifier
1295137693
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2472 Issued in OR
Practice address
6514 SE 42ND Ave
Portland, OR 97206-7702
Phone
(503) 972-7090
Fax
(833) 527-3447
NPI assigned
Sep 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2472 OR Primary

Addresses

Primary practice location

6514 SE 42ND Ave
Portland, OR 97206-7702

Mailing address

4207 SE Woodstock Blvd # 411
Portland, OR 97206-6267
Phone (503) 972-7090

Other practice location 1

3735 SW River Pkwy
Portland, OR 97239-4560
Phone (503) 972-7090

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141003002302 OR Practitioner - Clinical Psychologist 2062641913 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

6514 SE 42ND Ave
Portland, OR 97206-7702
Phone (503) 972-7090

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Sep 1, 2018 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Sep 1, 2018 Accepting new patients
Transitions Professional Center CurrentSince May 17, 2020 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3735 S River Pkwy
Portland, OR 97239
Phone (503) 972-7090

4207 SE Woodstock Blvd
Portland, OR 97206
Phone (503) 312-6005

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

Interoperability endpoints

  • Direct secure messaging: lmarasco109268@direct.ohsu.edu

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1295137693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 SE WOODSTOCK BLVD # 411",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972066267",
            "telephone_number": "503-972-7090",
            "fax_number": "833-527-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6514 SE 42ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972067702",
            "telephone_number": "503-972-7090",
            "fax_number": "833-527-3447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3735 SW River Pkwy",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972394560",
            "country_code": "US",
            "telephone_number": "503-972-7090",
            "fax_number": "503-972-7093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARASCO",
        "first_name": "LOUISE",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.