THERESA LOUISE MORTENSEN N.P.
NPI 1972683753
Nurse Practitioner in Santa Rosa, CA

Q: What is Theresa Mortensen's NPI number?

The NPI number for Theresa Mortensen is 1972683753. It was assigned to this individual provider in the NPPES registry on October 16, 2006.

Q: What is Theresa Mortensen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Theresa Mortensen was last updated on November 8, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 16, 2006PECOS EnrolledAccepts Medicare Assignment

3555 ROUND BARN CIR, SANTA ROSA, CA 95403(707) 528-1050(707) 525-3874 Get Directions Write a Review

NPPES record last updated: November 8, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 8, 2021, Mar 29, 2021 (2 updates tracked since 2021).

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About Theresa Louise Mortensen N.p. NPPES

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

THERESA LOUISE MORTENSEN N.P. (NPI 1972683753) is an individual nurse practitioner in Santa Rosa, California, licensed in California (402482) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1972683753

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameTHERESA LOUISE MORTENSENCredential: N.P.

Location Address3555 ROUND BARN CIRSanta Rosa, CA 95403-1757

Mailing Address3555 Round Barn CirSanta Rosa, CA 95403-1757 · (707) 528-1050 · Fax (707) 525-3874

Phone(707) 528-1050

Fax(707) 525-3874

Sole ProprietorNo

Medical School CMSOtherGraduated 2002

Enumeration DateOctober 16, 2006

Last NPPES UpdateNovember 8, 20212 updates tracked since enumeration

NPPES CertifiedNovember 8, 2021

✔ NPI 1972683753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in CA · 402482

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

3555 ROUND BARN CIR, Santa Rosa, CA 95403

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Other Identifiers 1

MedicaidRN402482CA

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

Theresa Louise Mortensen N.p. 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 ID2769377449

PECOS Enrollment IDI20040220000454

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 2

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

40 services36 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95403 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

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$109.88 typical visit price

range $21.02 – $153.40

Typical copayment $27.47 (range $5.25 – $38.35)

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 17

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

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