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SAMUEL BRYAN VALDIVIA
NPI 1003439084
Physician Assistant in Portland, OR

Active since May 25, 2020PECOS EnrolledAccepts Medicare Assignment
86.03/100
CMS Quality Rating
501 N GRAHAM ST MEDICAL OFFICE BUILDING 2, SUITE 220, PORTLAND, OR 97227(503) 413-6200 Get Directions Write a Review

NPPES record last updated: October 28, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 28, 2022, May 25, 2020 (2 updates tracked since 2020).

About Samuel Bryan Valdivia NPPES

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

SAMUEL BRYAN VALDIVIA (NPI 1003439084) is an individual physician assistant in Portland, Oregon, licensed in Oregon (PA213719) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS, is affiliated with Legacy Emanuel Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1003439084
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameSAMUEL BRYAN VALDIVIA
Location Address501 N GRAHAM ST MEDICAL OFFICE BUILDING 2, SUITE 220Portland, OR 97227
Mailing Address1701 Sw Columbia St Apt 404Portland, OR 97201-2592 · (602) 403-5363
Phone(503) 413-6200
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateMay 25, 2020
Last NPPES UpdateOctober 28, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 23, 2022
✔ NPI 1003439084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in OR · PA213719
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
501 N GRAHAM ST MEDICAL OFFICE BUILDING 2, Portland, OR 97227
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Secondary Practice Locations 2

Location 11701 SW Columbia St Apt 404Portland, OR 97201-2592 · Phone (602) 403-5363
Location 2222 SE 8th Ave Ste 536Hillsboro, OR 97123-4218 · Phone (503) 352-7272

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., 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

Samuel Bryan Valdivia 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 ID5698142628
PECOS Enrollment IDI20221104000685
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.

Hospital Affiliations CMS Care Compare 3

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

Legacy Emanuel Medical Center

Acute Care Hospitals · Portland, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380007
Location2801 N Gantenbein AvenuePortland, OR 97227 · Multnomah County
Emergency services Birthing friendly

Legacy Good Samaritan Medical Center

Acute Care Hospitals · Portland, OR
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380017
Location1015 NW 22nd Avenue, W121Portland, OR 97210 · Multnomah County
Emergency services Birthing friendly

Legacy Meridian Park Medical Center

Acute Care Hospitals · Tualatin, OR
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380089
Location19300 SW 65th AvenueTualatin, OR 97062 · Washington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97227 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
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
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.

86.03/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.8
Promoting Interoperability99
Improvement Activities40
Cost74.15

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 Samuel Valdivia's NPI number?

The NPI number for Samuel Valdivia is 1003439084. It was assigned to this individual provider in the NPPES registry on May 25, 2020.

Where is Samuel Valdivia located?

Samuel Valdivia practices at 501 N Graham St Medical Office Building 2 Suite 220, Portland, OR 97227. The listed phone number is (503) 413-6200.

What is Samuel Valdivia's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Samuel Valdivia enrolled in Medicare?

Yes. Samuel Valdivia 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 Samuel Valdivia accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Samuel Valdivia 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.

Is Samuel Valdivia affiliated with any hospitals?

According to CMS data, Samuel Valdivia is affiliated with Legacy Emanuel Medical Center, Legacy Good Samaritan Medical Center and Legacy Meridian Park Medical Center.

When was this NPI record last updated?

The NPPES record for Samuel Valdivia was last updated on October 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.