Individual provider Active NPI

Margie Elizabeth Hertz, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1669916383
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
202205308NP-PP Issued in OR
Practice address
4212 NE Broadway
Portland, OR 97213-1422
Phone
(503) 249-8787
NPI assigned
Dec 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 202205308NP-PP OR Primary
Registered Nurse 163W00000X 201500166RN OR

Addresses

Primary practice location

4212 NE Broadway
Portland, OR 97213-1422

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_bmc_internal_med_broadway_front_desk_pool12226299@oc.providencedirect.org The Oregon Clinic PC

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
I20240806000792 OR Practitioner - Nurse Practitioner 8820535099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Broadway Medical Clinic LLPGroup PAC ID 2466447610, 18 clinicians
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

4212 NE Broadway
Portland, OR 97213-1422
Phone (503) 249-8787

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201500166RNORMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Networks on Demand, LLC CurrentSince Jul 17, 2024 Accepting new patients
Zoomcare Urgent Care LLC PastSince Aug 6, 2023 Accepting new patients

Locations

10221 SE Sunnyside Rd
Clackamas, OR 97015

2490 Willamette St
Ste 4
Eugene, OR 97405
Phone (541) 746-7671

3060 SE Hawthorne Blvd
Portland, OR 97214

3325 SE Hawthorne Blvd
Portland, OR 97214

2990 Commercial St SE
Ste 160
Salem, OR 97302

Interoperability endpoints

  • Direct secure messaging: margie.hertz.1@30646.direct.athenahealth.com

Organizations & group practices 4

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": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1669916383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 NE BROADWAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131422",
            "telephone_number": "503-249-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZ",
        "first_name": "MARGIE",
        "middle_name": "ELIZABETH",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-14",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202205308NP-PP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201500166RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_bmc_internal_med_broadway_front_desk_pool12226299@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "4212 NE Broadway",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972131422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.