Kimberlie Anne Dame, AGPCNP - Medicare Nurse Practitioner in Portland, OR

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Kimberlie Anne Dame, AGPCNP is a medicare enrolled "Nurse Practitioner - Gerontology" in Portland, Oregon. Her current practice location is 9135 Sw Barnes Rd Ste 261, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 216-6300.

Kimberlie Anne Dame is licensed to practice in Oregon (license number 10008811) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1366134843.

Contact Information

Kimberlie Anne Dame, AGPCNP
9135 Sw Barnes Rd Ste 261,
Portland, OR 97225-6784
(503) 216-6300
Not Available

Map and Direction




Provider's Profile

Full NameKimberlie Anne Dame
GenderFemale
SpecialityNurse Practitioner - Gerontology
Location9135 Sw Barnes Rd Ste 261, Portland, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1366134843
  • Provider Enumeration Date: 05/23/2023
  • Last Update Date: 11/02/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 9931562873
  • Enrollment ID: I20230825000809

Medical Identifiers

Medical identifiers for Kimberlie Anne Dame such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1366134843NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2200XNurse Practitioner - Adult Health 10008811 (Oregon)Secondary
363LG0600XNurse Practitioner - Gerontology 10008811 (Oregon)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberlie Anne Dame allows following entities to bill medicare on her behalf.
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023488343
PECOS PAC ID: 0648183608
Enrollment ID: O20031106000652
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003991845
PECOS PAC ID: 5395656284
Enrollment ID: O20031113000626
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114015971
PECOS PAC ID: 9335057447
Enrollment ID: O20031117000153
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578500492
PECOS PAC ID: 1557260106
Enrollment ID: O20040102000768
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053862714
PECOS PAC ID: 7315856010
Enrollment ID: O20040304001330

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberlie Anne Dame is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kimberlie Anne Dame, AGPCNP
Po Box 3158,
Portland, OR 97208-3158

Ph: (503) 215-6494		Kimberlie Anne Dame, AGPCNP
9135 Sw Barnes Rd Ste 261,
Portland, OR 97225-6784

Ph: (503) 216-6300

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.