Individual provider Active NPI

Brooke Ottman, FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1497388797
Registry record updated May 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202003090NP-PP Issued in OR
Practice address
10123 SE Market St
Portland, OR 97216-2532
Phone
(503) 257-2500
NPI assigned
Feb 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN61057277 WA
Medical-Surgical Registered Nurse 163WM0705X 201141939RN OR
Family Nurse Practitioner 363LF0000X AP61057326 WA
Family Nurse Practitioner 363LF0000X 202003090NP-PP OR Primary

Addresses

Primary practice location

10123 SE Market St
Portland, OR 97216-2532

Mailing address

10123 SE Market St
Portland, OR 97216-2532

Other names 1

  • Brooke Carstensen Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ottmanbm@ah.org Direct

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
I20200817001939 OR Practitioner - Nurse Practitioner 4587080916 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
Marquis Clinical Services LLCGroup PAC ID 2860827821, 24 clinicians

Practice addresses (Care Compare)

4560 SE International Way
Suite 100
Milwaukie, OR 97222-4628
Phone (971) 206-5164

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN61057277WAMDRegistered Nurse
AP61057326WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marquis Clinical Services LLC Family CurrentSince Aug 10, 2020 Accepting new patients

Locations

4560 SE International Way
Ste 100
Portland, OR 97222
Phone (971) 206-5129

Interoperability endpoints

  • Direct secure messaging: ottmanbm@ah.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1581724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588377600000",
    "number": "1497388797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10123 SE MARKET ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10123 SE MARKET ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162532",
            "telephone_number": "503-257-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTMAN",
        "first_name": "BROOKE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-15",
        "last_updated": "2020-05-02",
        "certification_date": "2020-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61057277",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "OR",
            "license": "201141939RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61057326",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202003090NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ottmanbm@ah.org",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Emaik",
            "address_1": "10123 SE Market St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972162532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "CARSTENSEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.