Gina Dora Patriarca, QMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

847 NE 19TH Ave Ste 100
Portland, OR 97232

Phone

(503) 238-1769

NPI assigned

Aug 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Portland DBT Institute IncGroup PAC ID 7911141742, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Portland DBT Institute, Inc.

  • Cognitive & Behavioral Psychologist
  • Portland, OR
  • NPI 1073853966
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1427066604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459",
            "telephone_number": "503-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "503-238-1769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 SW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972052329",
            "country_code": "US",
            "telephone_number": "503-552-0767",
            "fax_number": "503-944-2595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRIARCA",
        "first_name": "GINA",
        "middle_name": "DORA",
        "name_prefix": "Mrs.",
        "credential": "QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Patino
• Tina Patnode, RD, LD
• Emily Lauren Paton
• Gillian Rae Paton, MD
• Rachael Anne Patoray, LPC- LICENSED PROFES
• Amelia Dore Patrice, MSW, CSWA
• Patricia a. Burford, M.D., P.C.
• Patricia Camplair, PHD PC
• Patricia Hallam, Lac, LLC
• Patricia Owens

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.

Verify at the official NPI Registry.