KATHERINE FELICIA EDSTROM (AGNP-C) – Gerontology Nurse Practitioner, NPI 1043862550

KATHERINE FELICIA EDSTROM (AGNP-C) is a healthcare provider. based in Portland, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials AGNP-C. They hold a License No. 201905490NP-PP (OR). The NPI Number for KATHERINE FELICIA EDSTROM (AGNP-C) is 1043862550

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
KATHERINE FELICIA EDSTROM (AGNP-C)
NPI
1043862550
Phone
(503) 494-8562
Address
3181 SW SAM JACKSON PARK RD
Enumeration Date
15 July 2019
Last Update Date
17 May 2024

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
9712025500
Graduation Year
2019 (7 years ago)
PAC ID
4082945050
Group Practice PAC ID
7113297789
Professional Enrollment ID
I20191007002307
Address ID
OR972393827PO5100XAVEX405
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

3,366 NURSE PRACTITIONER in OR

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Provider Addresses for KATHERINE FELICIA EDSTROM (AGNP-C)

  • Richard T. Jones Hall, 3181, Southwest Sam Jackson Park Road, Marquam Hill, Homestead, Portland, Metro, Multnomah County, Oregon, 97239, United States

    PORTLAND, OR 972393011

    Phone: (503) 494-8562

    Fax: (503) 418-5505

    Type: Location

  • 3181 SW Sam Jackson Park Rd

    Portland, OR 972393011

    Phone: (503) 494-8562

    Fax: (503) 418-5505

    Type: Location

  • 5100 S MACADAM AVE STE 200

    PORTLAND, OR 972393827

    Phone: (971) 202-5500

    Fax: (971) 202-5555

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-10-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20191007002307INurse PractitionerORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes5431$0
99310Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes3525$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes1714$0
99316Nursing facility discharge management, more than 30 minutes1717$0
View full utilization report →

Insurance plans in this area (ZIP 97239)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7113297789View full group profile
NameSpecialtyState
-OR
Nurse PractitionerOR
Nurse PractitionerOR
-OR
Physician AssistantOR
Internal MedicineOR
Nurse PractitionerOR
Physician AssistantOR
Nurse PractitionerOR
Nurse PractitionerOR

Reviews

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Frequently asked questions

What number should I use to identify KATHERINE FELICIA EDSTROM (AGNP-C) for billing?
Administrative and clinical systems typically use NPI 1043862550 for KATHERINE FELICIA EDSTROM (AGNP-C).
Does the public listing show KATHERINE FELICIA EDSTROM (AGNP-C) as active?
KATHERINE FELICIA EDSTROM (AGNP-C)'s NPI record reflects an active status in NPPES.
What services align with KATHERINE FELICIA EDSTROM (AGNP-C)'s listing?
KATHERINE FELICIA EDSTROM (AGNP-C)'s public classification highlights Gerontology Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to KATHERINE FELICIA EDSTROM (AGNP-C)?
The directory associates KATHERINE FELICIA EDSTROM (AGNP-C) with Portland, Oregon. Check all listed addresses for suites or satellite offices.
Can I export KATHERINE FELICIA EDSTROM (AGNP-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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