Individual provider Active NPI

Maret Pfohman, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Oregon City, OR
National Provider Identifier
1821585407
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201706030NP-PP Issued in OR
Practice address
998 Library CT
Oregon City, OR 97045-4041
Phone
(503) 655-8401
NPI assigned
Apr 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201706030NP-PP OR Primary

Addresses

Primary practice location

998 Library CT
Oregon City, OR 97045-4041

Mailing address

1543 SE Tolman St
Portland, OR 97202-5423

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
I20180710001989 OR Practitioner - Nurse Practitioner 8022364843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Clackamas Office of County AuditorGroup PAC ID 9537065560, 75 clinicians

Practice addresses (Care Compare)

150 Beavercreek Rd
Oregon City, OR 97045-4302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
201706030NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clackamas County Current Accepting new patients
County of Clackamas Office of County Auditor CurrentSince Aug 6, 2018 Accepting new patients

Locations

2051 Kaen Rd
Ste 367
Oregon City, OR 97045
Phone (503) 742-5300

998 Courthouse Rd
Oregon City, OR 97045
Phone (503) 655-8470

110 Beavercreek Rd
Oregon City, OR 97045
Phone (503) 655-8470

6605 SE Lake Rd
Portland, OR 97222
Phone (503) 665-8471

Interoperability endpoints

  • Direct secure messaging: mpfohman240615@direct.ochin.org

Organizations & group practices 2

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": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1821585407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 SE TOLMAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972025423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 LIBRARY CT",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454041",
            "telephone_number": "503-655-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFOHMAN",
        "first_name": "MARET",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201706030NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

Verify at the official NPI Registry.