Individual provider Active NPI

Melissa Lynett Federspiel, FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1881676641
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200350112NP Issued in OR
Practice address
5736 NE Glisan St
Portland, OR 97213-3750
Phone
(971) 258-1120
NPI assigned
Nov 17, 2005
Sex
Female
Sole proprietor
No

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sellwood Medical Clinic PC 6 clinicians

Practice addresses (Care Compare)

8332 SE 13TH Ave
Portland, OR 97202-7102
Phone (503) 595-9300

Hospital & facility affiliations

  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20070224000093 OR Practitioner - Nurse Practitioner 7214937309 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Aug 29, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 29, 2022 Accepting new patients
Sellwood Medical Clinic PC CurrentSince Sep 15, 2024 Accepting new patients

Locations

8332 SE 13th Ave
Portland, OR 97202
Phone (503) 595-9300

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

Interoperability endpoints

  • Direct secure messaging: mfederspiel2521103@oc.providencedirect.org
  • FHIR API: https://api.platform.athenahealth.com/3083/brand/1/csg/1/fhir/r4
  • Direct secure messaging: melissa.federspiel.1@3083.direct.athenahealth.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 200350112NP OR Primary

Addresses

NPPES NPI Registry

Primary practice location

5736 NE Glisan St
Portland, OR 97213-3750

Mailing address

5736 NE Glisan St
Portland, OR 97213-3750
Phone (971) 258-1120

Other practice location 1

8935 SE Powell Blvd
Portland, OR 97266-1938
Phone (503) 772-4335

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
J555 08OtherPACIFIC SOURCE
911019392OtherCOMMERCIAL

Other names 1

NPPES NPI Registry
  • Melissa M Lynett Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 9, 2022.

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1881676641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5736 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133750",
            "telephone_number": "971-258-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5736 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133750",
            "telephone_number": "971-258-1120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8935 SE Powell Blvd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972661938",
            "country_code": "US",
            "telephone_number": "503-772-4335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDERSPIEL",
        "first_name": "MELISSA",
        "middle_name": "LYNETT",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200350112NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC SOURCE",
            "identifier": "J555 08",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "911019392",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "LYNETT",
            "middle_name": "M",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.