Individual provider Active NPI

Nicole Benthin, NP

  • Family Nurse Practitioner
  • Seaside, OR
National Provider Identifier
1407400500
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201905533NP-PP Issued in OR
Practice address
725 S Wahanna Rd Ste 230
Seaside, OR 97138-7735
Phone
(503) 741-7060
NPI assigned
Jul 26, 2019
Last updated
Sep 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201905533NP-PP OR Primary

Addresses

Primary practice location

725 S Wahanna Rd Ste 230
Seaside, OR 97138-7735

Mailing address

PO Box 783
Astoria, OR 97103-0783
Phone (503) 791-4156

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nbenthin114092@oc.providencedirect.org

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
I20190919001028 OR Practitioner - Nurse Practitioner 0941530869 Reassigns benefits to 2 organizations

Care Compare profile

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

Practice addresses (Care Compare)

7305 SE Circuit Dr
Suite 270
Hillsboro, OR 97129-1966
Phone (503) 342-9931

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201905533NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Dec 1, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2019 Accepting new patients

Locations

440 NW Division St
Gresham, OR 97030
Phone (503) 215-9500

5555 NE Elam Young Pkwy
Hillsboro, OR 97124
Phone (503) 216-1600

7305 SE Circuit Dr
Ste 270
Hillsboro, OR 97129
Phone (503) 207-9463

2400 E Douglas Ave
Bldg K
Newberg, OR 97132
Phone (971) 231-5855

5330 NE Glisan St
Ste 100
Portland, OR 97213
Phone (503) 215-9700

9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

725 S Wahanna Rd
Ste 230
Seaside, OR 97138
Phone (503) 717-7060

727 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Interoperability endpoints

  • Direct secure messaging: nbenthin114092@oc.providencedirect.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1407400500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971030783",
            "telephone_number": "503-791-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S WAHANNA RD STE 230",
            "city": "SEASIDE",
            "state": "OR",
            "postal_code": "971387735",
            "telephone_number": "503-741-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTHIN",
        "first_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-26",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201905533NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nbenthin114092@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "727 S Wahanna Rd",
            "city": "Seaside",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971387735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seaside, OR

Sources for this page

Verify at the official NPI Registry.