Active NPI
Martha Cecilia Reyna, ARNP
- Family Nurse Practitioner
- Boardman, OR
National Provider Identifier
1417820135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 10035020
- Practice address
- 450 Tatone St
Boardman, OR 97818-8076 - Phone
- (541) 481-7212
- NPI assigned
- Sep 29, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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.
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Columbia River Health
Practice addresses (Care Compare)
450 Tatone St
Boardman, OR 97818-8076
Phone (541) 481-7212
Hospital & facility affiliations
- Good Shepherd Medical Center
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251111000637 | OR | Practitioner - Nurse Practitioner | 0941790620 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10035020 | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia River Health | Current | Accepting new patients |
Locations
450 Tatone St
Boardman, OR 97818
Phone (541) 481-7212
Interoperability endpoints
- mhurtado771707@direct.ochin.org
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 10035020 | OR | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
450 Tatone St
Boardman, OR 97818-8076
Mailing address
PO Box 397
Boardman, OR 97818-0397
Phone (541) 481-7212
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500865454 | Medicaid | OR |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 29, 2026.
{
"created_epoch": "1759104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785283200000",
"number": "1417820135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 397",
"city": "BOARDMAN",
"state": "OR",
"postal_code": "978180397",
"telephone_number": "541-481-7212",
"fax_number": "541-481-5447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 TATONE ST",
"city": "BOARDMAN",
"state": "OR",
"postal_code": "978188076",
"telephone_number": "541-481-7212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNA",
"first_name": "MARTHA",
"middle_name": "CECILIA",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-29",
"last_updated": "2026-07-29",
"certification_date": "2026-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "10035020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500865454",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boardman, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.