Individual provider Active NPI

Robert Kleinjan, CSWA

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1740688803
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L7484 Issued in OR
Practice address
33 NW Broadway
Portland, OR 97209-3580
Phone
(503) 228-7134
NPI assigned
Dec 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Social Worker 104100000X
Clinical Social Worker 1041C0700X L7484 OR Primary

Addresses

Primary practice location

33 NW Broadway
Portland, OR 97209-3580

Mailing address

232 NW 6TH Ave
Portland, OR 97209-3609
Phone (503) 294-1681

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
I20241226000685 OR Practitioner - Clinical Social Worker 6103187497 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. Clinical CurrentSince Oct 20, 2024 Accepting new patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Oct 20, 2024 Accepting new patients
Optum Behavioral Care of Colorado, P.C. Current Accepting new patients

Locations

11000 Optum Cir
Eden Prairie, MN 55344
Phone (888) 445-8745

1306 NW Hoyt St
Ste 407
Portland, OR 97209
Phone (971) 407-3930

Interoperability endpoints

  • Direct secure messaging: robert.kleinjan.1@28621.direct.athenahealth.com

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": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1740688803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 NW 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093609",
            "telephone_number": "503-294-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 NW BROADWAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093580",
            "telephone_number": "503-228-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINJAN",
        "first_name": "ROBERT",
        "credential": "CSWA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-05",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.