AMY KATHERINE HENNINGER (MD) – Family Medicine Physician, NPI 1083629588
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,081 FAMILY PRACTICE in OR
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Provider Addresses for AMY KATHERINE HENNINGER (MD)
Multnomah County Veterans Services East County ADVSD Branch Office, 600, Northeast 8th Street, Gresham, Metro, Multnomah County, Oregon, 97030, United States
3RD FLOOR
GRESHAM, OR 970307317
Phone: (503) 988-5155
Fax: (503) 988-5185
Type: Mailing
Lincoln Building, 421, Southwest Oak Street, Portland Downtown, Portland, Metro, Multnomah County, Oregon, 97204, United States
PORTLAND, OR 972041817
Phone: (503) 988-7458
Fax: (503) 988-3015
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: 2005-05-16
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050516000569 | I | Family Practice | OR | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 83036 | Hemoglobin a1c level | 16 | 16 | $0 |
Insurance plans in this area (ZIP 97030)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OR | |
| - | OR | |
| Physician Assistant | OR | |
| Physician Assistant | OR | |
| Clinical Psychologist | OR | |
| - | OR | |
| Family Practice | OR | |
| Clinical Social Worker | OR | |
| Nurse Practitioner | WA | |
| - | OR |
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