Individual provider Active NPI

Mary E Martel, FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1497897466
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201703079NP-PP Issued in OR
Practice address
4805 NE Glisan St Ste 11N
Portland, OR 97213-2933
Phone
(503) 215-1350
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201703078 OR
Registered Nurse 163W00000X RN60743697 WA
Family Nurse Practitioner 363LF0000X 201703079NP-PP OR Primary
Nurse Practitioner 363L00000X AP60744184 WA
Nurse Practitioner 363L00000X 201703079 OR

Addresses

Primary practice location

4805 NE Glisan St Ste 11N
Portland, OR 97213-2933

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

3060 SE Hawthorne Blvd Ste 1
Portland, OR 97214-4121
Phone (855) 235-0491

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200227002618 OR Practitioner - Nurse Practitioner 4284822503 Reassigns benefits to 5 organizations
I20200227002707 WA Practitioner - Nurse Practitioner 4284822503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services - OregonGroup PAC ID 5395656284, 195 clinicians
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

Hospital & facility affiliations

  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201703078ORMDRegistered Nurse
201703079ORMDNurse Practitioner
AP60744184WAMDNurse Practitioner
201703079NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Aug 1, 2024 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2024 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jan 8, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2024 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jan 8, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jan 8, 2020 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2024 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

4805 NE Glisan St
Ste 11N
Portland, OR 97213
Phone (503) 215-1350

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

3060 SE Hawthorne Blvd
Ste 1
Portland, OR 97214
Phone (855) 235-0491

3060 SE Hawthorne Blvd
Ste 13060
Portland, OR 97214

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

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

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

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: mmartel3367823@oc.providencedirect.org

Organizations & group practices 13

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.

View all 13

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1497897466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST STE 11N",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-1350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3060 SE Hawthorne Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972144121",
            "country_code": "US",
            "telephone_number": "855-235-0491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTEL",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201703078",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60743697",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201703079NP-PP",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60744184",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201703079",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "11245 Huron St",
            "city": "Westminster",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802342866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "11245 Huron St",
            "city": "Westminster",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802342866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.