Individual provider Active NPI

Jillian K Rosenthal, ANP

  • Nurse Practitioner
  • Portland, OR
National Provider Identifier
1730748732
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
202007157NP Issued in OR
Practice address
10201 SE Main St Ste 27
Portland, OR 97216-2937
Phone
(503) 256-0877
Fax
(503) 256-4188
NPI assigned
Jun 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP61096051 WA
Nurse Practitioner 363L00000X 202007157NP OR Primary

Addresses

Primary practice location

10201 SE Main St Ste 27
Portland, OR 97216-2937

Mailing address

PO Box 3068
Portland, OR 97208-3068
Phone (503) 229-7976

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
I20210216003177 OR Practitioner - Nurse Practitioner 7214268697 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
Telehealth
Offers telehealth services
Group practices
Northwest Renal Clinic IncGroup PAC ID 8628065836, 39 clinicians

Practice addresses (Care Compare)

10201 SE Main St
Suite 27
Portland, OR 97216-2937
Phone (503) 256-0877

Hospital & facility affiliations

  • Adventist Health Portland Hospital, Portland, OR, CCN 380060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202007157NPORMDNurse Practitioner
AP61096051WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Renal Clinic, Inc. Current Accepting new patients
Northwest Renal Clinic, Inc. CurrentSince Feb 22, 2021 Accepting new patients
Northwest Renal Clinic, Inc. CurrentSince Feb 22, 2021 Accepting new patients
Northwest Renal Clinic, Inc. Past Accepting new patients

Locations

1130 NW 22nd Ave
Ste 640
Portland, OR 97210
Phone (503) 229-7976

10201 SE Main St
Ste 27
Portland, OR 97216
Phone (503) 256-0877

Interoperability endpoints

  • Direct secure messaging: jrosenthal42181@direct.acumenmd.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.

Hospital & facility affiliations 1

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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1730748732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3068",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083068",
            "telephone_number": "503-229-7976",
            "fax_number": "503-274-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 SE MAIN ST STE 27",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162937",
            "telephone_number": "503-256-0877",
            "fax_number": "503-256-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "JILLIAN",
        "middle_name": "K",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61096051",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202007157NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.