NPIMap

Individual provider Active NPI

Benjamin J Hartwig, AGACNP

  • Acute Care Nurse Practitioner
  • Portland, OR
National Provider Identifier
1578008397
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
201706637NP-PP Issued in OR
Practice address
4400 NE Halsey St Ste 102
Portland, OR 97213-1545
Phone
(503) 962-1000
NPI assigned
Jan 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 201706637NP-PP OR
Acute Care Nurse Practitioner 363LA2100X 201706637NP-PP OR Primary

Addresses

Primary practice location

4400 NE Halsey St Ste 102
Portland, OR 97213-1545

Mailing address

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

Other practice location 1

1111 NE 99th Ave Ste 201
Portland, OR 97220-9442
Phone (503) 962-1000

Other identifiers 1

IdentifierTypeStateIssuer
500740964MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bhartwig315631@oc.providencedirect.org
Direct Messaging Address bhartwig315631@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180327002925 OR Practitioner - Nurse Practitioner 2860754009 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Oregon Health Sciences University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1510 Division St
Suite 100
Oregon City, OR 97045-1572
Phone (503) 962-1000

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

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-2213

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Apr 1, 2018 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 1, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 1, 2018 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 1, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 1, 2018 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 1, 2018 Accepting new patients

Locations

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

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

1510 Division St
Ste 100
Oregon City, OR 97045
Phone (503) 216-6050

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

10330 SE 32nd Ave
Ste 210
Portland, OR 97222
Phone (503) 652-1456

9427 SW Barnes Rd
Ste 495
Portland, OR 97225
Phone (503) 216-0900

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

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

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

4400 NE Halsey St
Ste 102
Portland, OR 97213
Phone (503) 216-0990

1111 NE 99th Ave
Ste 201
Portland, OR 97220
Phone (503) 962-1020

960 N 16th St
Ste 304
Springfield, OR 97477
Phone (541) 744-6172

Interoperability endpoints

  • Direct secure messaging: bhartwig315631@oc.providencedirect.org

Organizations & group practices 7

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 7

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": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1578008397",
    "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": "4400 NE HALSEY ST STE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131545",
            "telephone_number": "503-962-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 NE 99th Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972209442",
            "country_code": "US",
            "telephone_number": "503-962-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTWIG",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-03",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "201706637NP-PP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "201706637NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500740964",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bhartwig315631@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1111 NE 99th Ave Ste 201",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972209442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bhartwig315631@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9427 SW Barnes Rd Ste 495",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.