MARYAM SAUDAGARAN AGPCNP
NPI 1083248504
Nurse Practitioner - Gerontology in Portland, OR
About Maryam Saudagaran Agpcnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARYAM SAUDAGARAN AGPCNP (NPI 1083248504) is an individual gerontology provider in Portland, Oregon, licensed in Oregon (10008586) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS, is affiliated with Providence St Vincent Medical Center, and maintains a secondary practice location in Portland.
NPPES Registry Identity
Specialties & Licenses 3
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Maryam Saudagaran Agpcnp 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.
Medicare Billing Reassignments
4Medicare enrollment records show Maryam Saudagaran reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Portland, OR 97213
- Reassigned Medicare billing, Oregon enrollment
- 22 clinicians in this Medicare group
Portland, OR 97213
- Reassigned Medicare billing, Oregon enrollment
- 1,501 clinicians in this Medicare group
Portland, OR 97213
- Reassigned Medicare billing, Oregon enrollment
- 676 clinicians in this Medicare group
Portland, OR 97225
- Reassigned Medicare billing, Oregon enrollment
- 753 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Providence St Vincent Medical Center
Acute Care Hospitals · Portland, ORProvidence Willamette Falls Medical Center
Acute Care Hospitals · Oregon City, ORProvidence Milwaukie Hospital
Acute Care Hospitals · Milwaukie, ORPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97213 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 9
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORTLAND, OR 97213
PORTLAND, OR 97213
PORTLAND, OR 97213
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 Maryam Saudagaran's NPI number?
The NPI number for Maryam Saudagaran is 1083248504. It was assigned to this individual provider in the NPPES registry on February 24, 2020.
Where is Maryam Saudagaran located?
Maryam Saudagaran practices at 6350 NE Halsey St, Portland, OR 97213. The listed phone number is (503) 215-2669.
What is Maryam Saudagaran's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Maryam Saudagaran enrolled in Medicare?
Yes. Maryam Saudagaran 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.
Which organizations bill Medicare for Maryam Saudagaran's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Maryam Saudagaran reassigns Medicare benefits to 4 organizations: Providence Health & Services Oregon (Portland, OR), Providence Health & Services - Oregon (Portland, OR), Providence Health & Services - Oregon (Portland, OR) and Providence Health & Services - Oregon (Portland, OR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Maryam Saudagaran's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Maryam Saudagaran affiliated with any hospitals?
According to CMS data, Maryam Saudagaran is affiliated with Providence St Vincent Medical Center, Providence Willamette Falls Medical Center and Providence Milwaukie Hospital.
When was this NPI record last updated?
The NPPES record for Maryam Saudagaran was last updated on November 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Maryam Saudagaran, AGPCNP · NPI 1083248504
Gerontology physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since February 24, 2020.
## Identity
- **NPI:** 1083248504 (Entity type: Individual)
- **Enumerated:** February 24, 2020
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** 10008586 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 6350 NE HALSEY ST, Portland, OR 97213-4720
- **Phone:** (503) 215-2669
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Providence Health & Services Oregon (NPI 1043366172, Portland, OR); Providence Health & Services - Oregon (NPI 1841466141, Portland, OR); Providence Health & Services - Oregon (NPI 1003991845, Portland, OR); Providence Health & Services - Oregon (NPI 1235259532, Portland, OR) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** November 2, 2023
- **Other identifiers:** Medicaid 2209323 (WA)
---
Source: [NPI Profile](https://npiprofile.com/npi/1083248504) · Data from the CMS NPPES public registry.