Individual provider Active NPI

Mary Geisler, RM

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1295587079
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10028482 Issued in OR
Practice address
905 SE 14TH Ave
Portland, OR 97214-2569
Phone
(503) 622-8964
NPI assigned
Apr 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 201390509RN OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10028482 OR Primary

Addresses

Primary practice location

905 SE 14TH Ave
Portland, OR 97214-2569

Mailing address

905 SE 14TH Ave
Portland, OR 97214-2569

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
I20250318000252 OR Practitioner - Nurse Practitioner 8224550421 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
Group practices
Larsen Sanchez Psychology LLCGroup PAC ID 6608138383, 17 clinicians

Practice addresses (Care Compare)

905 SE 14TH Ave
Portland, OR 97214-2569
Phone (503) 622-8964

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201390509RNORMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Larsen Sanchez Psychology, LLC Psychiatric/Mental Health CurrentSince Dec 31, 2024 Accepting new patients
Cansler Health, LLC Psychiatric/Mental Health PastSince Apr 1, 2024 Accepting new patients
Therapeutic Medical Weight Loss, LLC Psychiatric/Mental Health PastSince Apr 1, 2024 Accepting new patients

Locations

812 SW Washington St
Ste 700
Portland, OR 97205
Phone (503) 622-8964

905 SE 14th Ave
Portland, OR 97214
Phone (503) 622-8964

Organizations & group practices 3

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": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1295587079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 SE 14TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 SE 14TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142569",
            "telephone_number": "503-622-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEISLER",
        "first_name": "MARY",
        "credential": "RM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201390509RN",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10028482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.