ANDRENE BENJAMIN (PMHNP, FNP) – Family Nurse Practitioner, NPI 1164074456
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,261 NURSE PRACTITIONER in WA
Provider Addresses for ANDRENE BENJAMIN (PMHNP, FNP)
1220 Main St Ste 455
Vancouver, WA 986602963
Phone: (503) 647-6501
Fax: (503) 388-7702
Type: Location
1225 WILSHIRE BLVD APT 101
LOS ANGELES, CA 900171901
Phone: (213) 977-2121
Type: Location
306 LINCOLN RD
MIAMI BEACH, FL 331393103
Phone:
Type: Mailing
701 NE 136th Ave Ste 200
Vancouver, WA 986846937
Phone: (503) 664-9451
Fax: (503) 386-3230
Type: Location
555 SE MLK JR BLVD UNIT 105
PORTLAND, OR 972142595
Phone: (503) 664-9451
Fax: (503) 386-3230
Type: Location
310 SW 4TH AVE UNIT 3-H
PORTLAND, OR 972042345
Phone: (503) 647-6501
Fax: (503) 388-7702
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: 2025-04-11
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 |
|---|---|---|---|---|
| I20241121000324 | I | Nurse Practitioner | FL | TBD |
| I20250411002302 | I | Nurse Practitioner | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98660)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | MI | |
| Clinical Social Worker | MI | |
| Clinical Social Worker | MN | |
| Clinical Social Worker | OR | |
| Clinical Social Worker | CO | |
| Mental Health Counselor | MI | |
| Clinical Social Worker | CO | |
| Clinical Social Worker | OR | |
| Mental Health Counselor | CO | |
| Mental Health Counselor | CO |
Reviews
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