TIFFANY KETTERMANN, LLC
NPI 1003461740
Counselor - Mental Health in Portland, OR
About Tiffany Kettermann, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIFFANY KETTERMANN, LLC (NPI 1003461740) is a healthcare organization registered as a mental health in Portland, Oregon and active in the NPI registry since August 2019. The organization lists Tiffany Kettermann, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tiffany Kettermann, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
13Medicare enrollment records show 13 clinicians reassign Medicare billing to Tiffany Kettermann, LLC, which bills Medicare for the services they deliver. Of these, 5 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (13)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tiffany Kettermann, LLC's NPI number?
The NPI number for Tiffany Kettermann, LLC is 1003461740. It was assigned to this organization in the NPPES registry on August 8, 2019.
Where is Tiffany Kettermann, LLC located?
Tiffany Kettermann, LLC is located at 2950 SE Stark St Ste 130, Portland, OR 97214. The listed phone number is (971) 270-0167.
What is Tiffany Kettermann, LLC's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Tiffany Kettermann, LLC enrolled in Medicare?
Yes. Tiffany Kettermann, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tiffany Kettermann, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians in 4 Medicare specialties reassign their Medicare billing to Tiffany Kettermann, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (7), Mental Health Counselor (4) and Licensed Professional Counselor (1). Of these, 5 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Tiffany Kettermann, LLC accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Tiffany Kettermann, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Tiffany Kettermann, LLC was last updated on February 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Tiffany Kettermann, Llc · NPI 1003461740
Mental Health organization in Portland, Oregon. Organization record, active in the CMS NPPES registry since August 8, 2019.
## Identity
- **NPI:** 1003461740 (Entity type: Organization)
- **Enumerated:** August 8, 2019
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Organization subpart:** No
- **Authorized official:** Tiffany Kettermann, CEO
## Practice location
- **Address:** 2950 SE STARK ST STE 130, Portland, OR 97214-3082
- **Phone:** (971) 270-0167
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 13 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (7), Mental Health Counselor (4), Licensed Professional Counselor (1); 5 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 25, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1003461740) · Data from the CMS NPPES public registry.