Individual provider Active NPI

Hannah Masterton Fraser, PSYD

  • Clinical Psychologist
  • Springfield, OR
National Provider Identifier
1659936698
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3958 Issued in OR
Practice address
2280 Marcola Rd
Springfield, OR 97477-2594
Phone
(541) 747-3000
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3958 OR Primary

Addresses

Primary practice location

2280 Marcola Rd
Springfield, OR 97477-2594

Mailing address

2280 Marcola Rd
Springfield, OR 97477-2594
Phone (541) 747-3000

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250123001765 OR Practitioner - Clinical Psychologist 1658800453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwest Medical Homes, LLCGroup PAC ID 0042100372, 31 clinicians

Practice addresses (Care Compare)

2280 Marcola Rd
Springfield, OR 97477-2594
Phone (541) 747-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3958ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Medical Homes, LLC CurrentSince Jan 1, 2025 Accepting new patients
Northwest Medical Homes, LLC CurrentSince Jan 1, 2025 Accepting new patients
Pacific University Past Accepting new patients

Locations

2280 Marcola Rd
Springfield, OR 97477
Phone (541) 747-4300

1800 Centennial Blvd
Springfield, OR 97477
Phone (541) 747-4300

Organizations & group practices 3

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": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1659936698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 MARCOLA RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974772594",
            "telephone_number": "541-747-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 MARCOLA RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974772594",
            "telephone_number": "541-747-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "HANNAH",
        "middle_name": "MASTERTON",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.