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MARY ELIZABETH ROTBERG NP
NPI 1053866764
Nurse Practitioner - Family in Portland, OR

Active since August 23, 2016PECOS EnrolledAccepts Medicare Assignment
202 NW 13TH AVE, PORTLAND, OR 97209(503) 941-3844(503) 941-3777 Get Directions Write a Review

NPPES record last updated: December 30, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 30, 2021, Aug 23, 2016 (2 updates tracked since 2016).

About Mary Elizabeth Rotberg Np NPPES

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

MARY ELIZABETH ROTBERG NP (NPI 1053866764) is an individual family provider in Portland, Oregon, licensed in Oregon (201606595NP-PP) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1053866764
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARY ELIZABETH ROTBERGCredential: NP
Location Address202 NW 13TH AVEPortland, OR 97209-2953
Mailing Address19075 Nw Tanasbourne Dr Ste 200Hillsboro, OR 97124-5866 · (503) 941-3844
Phone(503) 941-3844
Fax(503) 941-3777
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 23, 2016
Last NPPES UpdateDecember 30, 20212 updates tracked since enumeration
NPPES CertifiedDecember 30, 2021
✔ NPI 1053866764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OR · 201606595NP-PP
202 NW 13TH AVE, Portland, OR 97209
Open in Google Maps ↗

Other Identifiers 1

Other201606595NP-PPOR · Np License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Kaiser Permanente.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

Mary Elizabeth Rotberg Np 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 ID9335479005
PECOS Enrollment IDI20190923001826
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97209 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.

Other Providers at the Same Location NPPES 11

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

PEACEHEALTH NETWORKS ON DEMAND, LLC
Non-Pharmacy Dispensing Site
202 NW 13TH AVE
PORTLAND, OR 97209
Multnomah County (503) 684-8252
MARK TYRRELL PA-C
Physician Assistant (Medical)
202 NW 13TH AVE
PORTLAND, OR 97209
Multnomah County (503) 684-8252
MICHELLE V. HUGGINS PHYSICIAN ASSISTANTE
Physician Assistant (Surgical)
202 NW 13TH AVE
PORTLAND, OR 97209
Multnomah County (971) 998-1011
JOHANNAH LUTZ PA-C
Physician Assistant (Medical)
202 NW 13TH AVE
PORTLAND, OR 97209
Multnomah County (503) 684-8252
CHRISTIAN MARCHANT PA-C
Physician Assistant (Medical)
202 NW 13TH AVE
PORTLAND, OR 97209
Multnomah County (503) 684-8252
RANDI REBECCA HERIFORD
Behavior Analyst
202 NW 13TH AVE
PORTLAND, OR 97209
Multnomah County (503) 684-8252
ZOOMCARE PC
Internal Medicine
202 NW 13TH AVE
PORTLAND, OR 97209
Multnomah County (503) 684-8252
ASHTON TART PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
202 NW 13TH AVE
PORTLAND, OR 97209
Multnomah County (503) 684-8252

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 Mary Rotberg's NPI number?

The NPI number for Mary Rotberg is 1053866764. It was assigned to this individual provider in the NPPES registry on August 23, 2016.

Where is Mary Rotberg located?

Mary Rotberg practices at 202 NW 13th Ave, Portland, OR 97209. The listed phone number is (503) 941-3844.

What is Mary Rotberg's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mary Rotberg enrolled in Medicare?

Yes. Mary Rotberg is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mary Rotberg accept?

Health plans from Kaiser Permanente list Mary Rotberg 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 Mary Rotberg was last updated on December 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.