Individual provider Active NPI

Matthew Crabtree, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1336780006
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201908704NP-PP Issued in OR
Practice address
1400 NW Irving St Apt 416
Portland, OR 97209-2254
Phone
(503) 893-4560
NPI assigned
Oct 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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 Practitioner 363LP0808X 201908704NP-PP OR Primary

Addresses

Primary practice location

1400 NW Irving St Apt 416
Portland, OR 97209-2254

Mailing address

1400 NW Irving St Apt 416
Portland, OR 97209-2254
Phone (503) 893-4560

Other practice location 1

1225 NE 2nd Ave
Portland, OR 97232-2003
Phone (503) 944-8000

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
I20210513001761 OR Practitioner - Nurse Practitioner 8426467929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1225 NE 2ND Ave
Portland, OR 97232-2003
Phone (503) 944-8000

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Mar 5, 2021 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Mar 5, 2021 Accepting new patients

Locations

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1225 NE 2nd Ave
Portland, OR 97232
Phone (503) 413-5051

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": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1336780006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 NW IRVING ST APT 416",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092254",
            "telephone_number": "503-893-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NW IRVING ST APT 416",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092254",
            "telephone_number": "503-893-4560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 NE 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972322003",
            "country_code": "US",
            "telephone_number": "503-944-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRABTREE",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-03",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201908704NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.