Benjamin Raj Anderson, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Portland, OR
NPI 1851090997 · NPPES record last updated Feb 27, 2023
Key facts
- NPI
- 1851090997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 10004862 (OR)
- Practice address
- 700 NE Multnomah St Ste 275
Portland, OR 97232-4103 - Phone
- (503) 729-1380
- NPI assigned
- Feb 27, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Willamette Health and Wellness LLC
Practice addresses (Care Compare)
700 NE Multnomah St
Suite 275
Portland, OR 97232-4103
Phone (503) 729-1380
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240412002818 | OR | Practitioner - Nurse Practitioner | 5092154823 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10004862 | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willamette Health & Wellness LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
Locations
700 NE Multnomah St
Ste 275
Portland, OR 97232
Phone (503) 729-1380
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 10004862 | OR | Yes |
Addresses
Primary practice location
700 NE Multnomah St Ste 275
Portland, OR 97232-4103
Mailing address
2057 N Willamette Blvd
Portland, OR 97217-4404
Phone (503) 686-0995
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | andersonb@whwpdx.com | Direct |
Other providers in Portland, OR
- April Anderson
- Ariel Anderson
- Ashley Nicole Anderson
- Ashley Rae Anderson
- Aunnah Anderson
- Bonnie L. Anderson
- Brad M Anderson
- Brandon Thomas Anderson
- Brenda J Anderson
- Britt Katherine Anderson
All providers in Portland, OR · Psychiatric/Mental Health Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.