DR. WILLOW NICOLE NAIMARK (MD) – Psychiatry Physician, NPI 1457556367

DR. WILLOW NICOLE NAIMARK (MD) is a healthcare provider. based in Portland, Oregon. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. MD150365 (OR). The NPI Number for DR. WILLOW NICOLE NAIMARK (MD) is 1457556367

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. WILLOW NICOLE NAIMARK (MD)
NPI
1457556367
Phone
Not provided
Address
4663 SW CULLEN BLVD
Enumeration Date
19 June 2007
Last Update Date
14 January 2025

Doctor Profile

Medical School Name
NEW YORK MEDICAL COLLEGE
Secondary Phone
5034520915
Graduation Year
2006 (20 years ago)
PAC ID
2668605957
Group Practice PAC ID
0042100521
Professional Enrollment ID
I20241113001807
Address ID
OR972191940PO2400XSTXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience70
Completeness75
Years active:18State licenses:1Digital endpointsOther names

454 PSYCHIATRY in OR

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Provider Addresses for DR. WILLOW NICOLE NAIMARK (MD)

  • 4663, Southwest Cullen Boulevard, Vermont Hills, Hayhurst, Portland, Metro, Multnomah County, Oregon, 97221, United States

    PORTLAND, OR 972212965

    Phone:

    Type: Mailing

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

    OREGON HEALTH AND SCIENCES UNIVERSITY, UHN-80

    PORTLAND, OR 972393011

    Phone: (503) 494-8311

    Fax: (503) 494-6152

    Type: Location

  • 2400 SW VERMONT ST

    PORTLAND, OR 972191940

    Phone: (503) 452-0915

    Type: Mailing

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: 2024-11-13

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
I20241113001807IPsychiatryORTBD

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 97221)

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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: 0042100521View full group profile
NameSpecialtyState
Internal MedicineOR
Internal MedicineOR
Internal MedicineOR
-OR
Internal MedicineOR
-OR
Internal MedicineOR
Physical Medicine And RehabilitationWA
Physical Therapist In Private PracticeNY
-OR

Reviews

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Frequently asked questions

How is DR. WILLOW NICOLE NAIMARK (MD) identified in CMS data?
CMS-hosted NPPES data lists DR. WILLOW NICOLE NAIMARK (MD) with NPI 1457556367.
Does the file indicate DR. WILLOW NICOLE NAIMARK (MD) is practicing under active NPI?
Directory data currently reports DR. WILLOW NICOLE NAIMARK (MD) as active.
What taxonomy line describes DR. WILLOW NICOLE NAIMARK (MD)?
For research purposes, treat DR. WILLOW NICOLE NAIMARK (MD) as Psychiatry Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect DR. WILLOW NICOLE NAIMARK (MD) on a map?
Expect Portland, Oregon as a primary anchor for DR. WILLOW NICOLE NAIMARK (MD) unless the record lists multiple sites.
Why does DR. WILLOW NICOLE NAIMARK (MD) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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