Tiffany Tomiye Roberts, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Cloverdale, OR
NPI 1861990780 · NPPES record last updated Dec 6, 2023
Key facts
- NPI
- 1861990780
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 10004660 (OR)
- Practice address
- 34980 Lahaina Loop Rd
Cloverdale, OR 97112-9112 - Phone
- (503) 310-3582
- NPI assigned
- Jan 25, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Peacehealth Networks on Demand LLC
Practice addresses (Care Compare)
2400 E Burnside St
Portland, OR 97214-1752
Phone (864) 664-3984
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.65 of 100
- Quality
- 86.8
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 86.36
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 92.23
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 100
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 |
|---|---|---|---|---|
| I20240205002595 | OR | Practitioner - Nurse Practitioner | 7113281247 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5010214 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth Networks on Demand, LLC | Current |
Accepting new patients | |
| Zoomcare PC | Past | Accepting new patients | |
| Zoomcare Urgent Care LLC | Past |
Accepting new patients |
Locations
11355 SW Scholls Ferry Rd
Beaverton, OR 97008
10221 SE Sunnyside Rd
Clackamas, OR 97015
2490 Willamette St
Ste 4
Eugene, OR 97405
Phone (541) 746-7671
17155 SE Sunnyside Rd
Ste 160
Happy Valley, OR 97015
Phone (503) 908-5634
7855 SW Capitol Hwy
Portland, OR 97219
2400 E Burnside St
Portland, OR 97214
Phone (503) 608-3081
2990 Commercial St SE
Ste 160
Salem, OR 97302
Interoperability endpoints
- https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 10004660 | OR | Yes |
| Family Nurse Practitioner | 363LF0000X | 5010214 | NC |
Addresses
Primary practice location
34980 Lahaina Loop Rd
Cloverdale, OR 97112-9112
Mailing address
PO Box 427
Pacific City, OR 97135-0427
Phone (503) 310-3582
Other practice location 1
2293 Sugar Hill Rd Ste D
Marion, NC 28752-7787
Phone (828) 652-8727
Other practice location 2
5920 US Highway 70 E
Nebo, NC 28761-9565
Phone (828) 659-9703
Other practice location 3
695 W Fleming Dr
Morganton, NC 28655-4450
Phone (828) 580-3278
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861990780 | Medicaid | NC |
Other providers in Cloverdale, OR
All providers in Cloverdale, OR · Family 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 Dec 6, 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.