MS. MARY ANN NAMETKA (DNP,MSN,CWON,FNP-BC) – Family Nurse Practitioner, NPI 1104835297
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,366 NURSE PRACTITIONER in OR
Provider Addresses for MS. MARY ANN NAMETKA (DNP,MSN,CWON,FNP-BC)
10121 SE SUNNYSIDE RD STE 300
CLACKAMAS, OR 970155713
Phone: (503) 888-0390
Fax: (888) 898-0933
Type: Mailing
7914 SE MAIN ST
PORTLAND, OR 972153031
Phone: (503) 888-0390
Fax: (888) 898-0933
Type: Mailing
951, Southeast Hawthorne Boulevard, Ladd's Addition, Hosford-Abernethy, Portland, Multnomah County, Oregon, 97214, United States
PORTLAND, OR 972145246
Phone: (503) 888-0390
Type: Mailing
Hartzo Hair Shop, 4410, Southeast Hawthorne Boulevard, Richmond, Portland, Multnomah County, Oregon, 97215, United States
PORTLAND, OR 972153165
Phone: (503) 420-5852
Fax: (844) 276-4208
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $293.
Total Amount is formed as General ($293) + Research ($0) + Ownership ($0) = $293.
Last reported payment date: 2024-11-08 • Largest payer in this snapshot: Urgo Medical North America, LLC ($160).
Total Amount
$293
General + Research + Ownership
Payments
5
Total payment records
General Amount
$293
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Urgo Medical North America, LLC | $160 |
| KCI USA, Inc. | $97 |
| Organogenesis Inc. | $21 |
| Smith+Nephew, Inc. | $15 |
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: 2012-03-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20071009000091 | I | Nurse Practitioner | OR | TBD |
| I20120313000472 | I | Nurse Practitioner | WA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97015)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA |
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