Individual provider Active NPI

Robert Martin

  • Family Nurse Practitioner
  • Gresham, OR
National Provider Identifier
1861992372
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10032757 Issued in OR
Practice address
2850 SE Powell Valley Rd
Gresham, OR 97080-1494
Phone
(503) 666-5050
NPI assigned
Feb 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9287512 FL
Family Nurse Practitioner 363LF0000X 10032757 OR Primary

Addresses

Primary practice location

2850 SE Powell Valley Rd
Gresham, OR 97080-1494

Mailing address

PO Box 3777
Portland, OR 97208-3777

Other practice location 1

4475 Willa Creek Dr Apt 111
Winter Springs, FL 32708-5227
Phone (407) 247-5810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, OR, WA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200310000296 MN Practitioner - Nurse Practitioner 2365870177 Reassigns benefits to 2 organizations
I20250401002405 OR Practitioner - Nurse Practitioner 2365870177 Reassigns benefits to 1 organization
I20250910002154 WA Practitioner - Nurse Practitioner 2365870177 Reassigns benefits to 2 organizations

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
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

2121 NE 139TH St
Vancouver, WA 98686-2316

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone 3604871000360487

2850 SE Powell Valley Rd
Gresham, OR 97080-1494
Phone (503) 666-5050

305 SE Chkalov Dr
Suite 170
Vancouver, WA 98683-5263
Phone (360) 799-3912

Hospital & facility affiliations

  • Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6492MNMDChiropractor
9287512FLMDFamily Nurse Practitioner
10032757ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Feb 1, 2020 Accepting new patients
Allina Health System CurrentSince Feb 1, 2020 Accepting new patients
Legacy Clinics LLC CurrentSince Mar 10, 2025 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System Past Accepting new patients
Legacy Salmon Creek Hospital Past Accepting new patients

Locations (25 of 36)

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

755 Crossroads Campus Dr NE
Buffalo, MN 55313
Phone (763) 684-6300

11269 Jefferson Hwy N
Champlin, MN 55316
Phone (763) 236-0600

100 State Ave
Faribault, MN 55021
Phone (507) 334-3921

5565 Blaine Ave
Ste 100
Inver Grove Heights, MN 55076
Phone (651) 241-9400

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

7373 France Ave S
Ste 202
Minneapolis, MN 55435
Phone (952) 835-1311

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

7373 France Ave S
Ste 208
Minneapolis, MN 55435
Phone (952) 835-1311

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

2833 Chicago Ave
Ste 406
Minneapolis, MN 55407

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

3270 W Lake St
Minneapolis, MN 55416
Phone (612) 775-1800

16725 County Road 24
Plymouth, MN 55447
Phone (763) 559-4669

14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141

1021 Bandana Blvd E
Ste 100
Saint Paul, MN 55108
Phone (877) 414-2533

6350 W 143rd St
Ste 200
Savage, MN 55378
Phone (952) 428-1010

4166 Lexington Ave N
Shoreview, MN 55126
Phone (651) 241-1306

4194 Lexington Ave N
Shoreview, MN 55126
Phone (651) 483-5461

5565 Blaine Ave
South St Paul, MN 55076
Phone (651) 241-9400

150 Emerson Ave E
West St Paul, MN 55118
Phone (651) 241-1800

8675 Valley Creek Rd
Woodbury, MN 55125
Phone (651) 241-3000

2870 SW Cedar Hills Blvd
Beaverton, OR 97005
Phone (503) 646-9222

22262 NE Glisan St
Gresham, OR 97030
Phone (503) 489-2024

2850 SE Powell Valley Rd
Gresham, OR 97080
Phone (503) 666-5050

Organizations & group practices 9

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 3

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": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1861992372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 SE POWELL VALLEY RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801494",
            "telephone_number": "503-666-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4475 Willa Creek Dr Apt 111",
            "address_purpose": "LOCATION",
            "city": "Winter Springs",
            "state": "FL",
            "postal_code": "327085227",
            "country_code": "US",
            "telephone_number": "407-247-5810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-20",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9287512",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10032757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.