RYAN GREGORY RESEBURG (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1275368474

RYAN GREGORY RESEBURG (PMHNP) is a healthcare provider. based in Portland, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 10032073 (OR). The NPI Number for RYAN GREGORY RESEBURG (PMHNP) is 1275368474

Main info

Male
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
RYAN GREGORY RESEBURG (PMHNP)
NPI
1275368474
Phone
(503) 400-4447
Address
2005 N WILLIAMS AVE APT 539
Enumeration Date
6 September 2024
Last Update Date
6 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5039445000
Graduation Year
2024 (2 years ago)
PAC ID
7113457516
Group Practice PAC ID
4981772639
Professional Enrollment ID
I20250214001784
Address ID
OR972255004PO10300STXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

3,366 NURSE PRACTITIONER in OR

Provider Addresses for RYAN GREGORY RESEBURG (PMHNP)

  • 2005 N WILLIAMS AVE APT 539

    PORTLAND, OR 972272057

    Phone: (503) 400-4447

    Type: Mailing

  • 10300 SW EASTRIDGE ST

    PORTLAND, OR 972255004

    Phone: (503) 944-5000

    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: 2025-02-14

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
I20250214001784INurse 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97227)

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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: 4981772639View full group profile
NameSpecialtyState
P S Y C H I A T R YOR
P S Y C H I A T R YIL
P S Y C H I A T R YOR
Nurse PractitionerOR
Nurse PractitionerIA
P S Y C H I A T R YOR
P S Y C H I A T R YTX
P S Y C H I A T R YOR
Nurse PractitionerOR
Nurse PractitionerTX

Reviews

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Frequently asked questions

What is RYAN GREGORY RESEBURG (PMHNP)'s NPI number?
RYAN GREGORY RESEBURG (PMHNP)'s NPI is 1275368474 — the number used across U.S. healthcare to identify this provider.
Would RYAN GREGORY RESEBURG (PMHNP) appear as active to a payer?
You can treat RYAN GREGORY RESEBURG (PMHNP) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to RYAN GREGORY RESEBURG (PMHNP)?
RYAN GREGORY RESEBURG (PMHNP)'s specialty line reads Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is RYAN GREGORY RESEBURG (PMHNP) associated with Portland?
Public fields place RYAN GREGORY RESEBURG (PMHNP) around Portland, Oregon. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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