KATHERINE FELICIA EDSTROM AGNP-C
NPI 1043862550
Nurse Practitioner - Gerontology in Portland, OR

Q: What is Katherine Edstrom's NPI number?

The NPI number for Katherine Edstrom is 1043862550. It was assigned to this individual provider in the NPPES registry on July 15, 2019.

Q: What is Katherine Edstrom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Katherine Edstrom was last updated on May 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.

Active since July 15, 2019PECOS EnrolledAccepts Medicare Assignment

97.83/100

CMS Quality Rating

5100 S MACADAM AVE STE 200, PORTLAND, OR 97239(971) 202-5500(971) 202-5555 Get Directions Write a Review

NPPES record last updated: May 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 17, 2024, Sep 17, 2019, Jul 15, 2019 (3 updates tracked since 2019).

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About Katherine Felicia Edstrom Agnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHERINE FELICIA EDSTROM AGNP-C (NPI 1043862550) is an individual gerontology provider in Portland, Oregon, licensed in Oregon (201905490NP-PP) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS, is affiliated with Adventist Health Portland, and maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1043862550

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameKATHERINE FELICIA EDSTROMCredential: AGNP-C

Location Address5100 S MACADAM AVE STE 200Portland, OR 97239-3827

Mailing Address3181 Sw Sam Jackson Park RdPortland, OR 97239-3011 · (503) 494-8562 · Fax (503) 418-5505

Phone(971) 202-5500

Fax(971) 202-5555

Sole ProprietorYes

Medical School CMSUniversity Of Washington School Of MedicineGraduated 2019

Enumeration DateJuly 15, 2019

Last NPPES UpdateMay 17, 20243 updates tracked since enumeration

NPPES CertifiedMay 17, 2024

✔ NPI 1043862550 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in OR · 201905490NP-PP

5100 S MACADAM AVE STE 200, Portland, OR 97239

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Secondary Practice Location 1

Location 13181 SW Sam Jackson Park RdPortland, OR 97239-3011 · Phone (503) 494-8562 · Fax (503) 418-5505

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Providence Health Plan, Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Katherine Felicia Edstrom Agnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082945050

PECOS Enrollment IDI20191007002307

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

65 services31 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

44 services21 patients

Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350

An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.

36 services22 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

20 services20 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

19 services19 patients

Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home M0201

The Covid-19 vaccine can be administered at your home for convenience and safety. This service is reported once per home, per date, when only the vaccine is given. It's a straightforward process where a medical professional visits your home to give the vaccine.

18 services18 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Adventist Health Portland

Acute Care Hospitals · Portland, OR

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number380060

Location10123 SE Market StreetPortland, OR 97216 · Multnomah County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97239 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.51 typical visit price

range $58.99 – $176.88

Typical copayment $22.62 (range $14.74 – $44.22)

Most-billed visit code 99203

Established Patient

$103.51 typical visit price

range $19.32 – $144.79

Typical copayment $25.87 (range $4.83 – $36.19)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.83/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.97

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers14 claims14 services$42.05 avg. paid by Medicare

Mycophenolate mofetil, oral, 250 mg J7517

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier11 claims660 services$0.20 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

1 supplier11 claims11 services$18.98 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMIE TILLER

Nurse Practitioner (Primary Care)