MR. ANDREW LEE SUMMERER PSYD
NPI 1063946176
Psychologist - Clinical in Portland, OR

Q: What is Andrew Summerer's NPI number?

The NPI number for Andrew Summerer is 1063946176. It was assigned to this individual provider in the NPPES registry on April 14, 2017.

Q: What is Andrew Summerer's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Andrew Summerer was last updated on May 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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 April 14, 2017PECOS EnrolledAccepts Medicare Assignment

2279 NW IRVING ST, PORTLAND, OR 97210(503) 218-3667 Get Directions Write a Review

NPPES record last updated: May 5, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 5, 2025, Oct 19, 2022, Oct 21, 2020 and 1 more (4 updates tracked since 2017).

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About Mr. Andrew Lee Summerer Psyd NPPES

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

MR. ANDREW LEE SUMMERER PSYD (NPI 1063946176) is an individual clinical provider in Portland, Oregon, licensed in Oregon (3280) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1063946176

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameMR. ANDREW LEE SUMMERERCredential: PSYD

Location Address2279 NW IRVING STPortland, OR 97210-3222

Mailing Address2279 Nw Irving StPortland, OR 97210-3222

Phone(503) 218-3667

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateApril 14, 2017

Last NPPES UpdateMay 5, 20254 updates tracked since enumeration

NPPES CertifiedMay 5, 2025

✔ NPI 1063946176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in OR · 3280

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

2279 NW IRVING ST, Portland, OR 97210

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Accepted Insurance

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

Mr. Andrew Lee Summerer Psyd 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 ID2062826399

PECOS Enrollment IDI20210128001023

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 97210 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

$176.88 typical visit price

range $58.99 – $176.88

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

Most-billed visit code 99205

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 7

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

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