MARYAM SAUDAGARAN AGPCNP
NPI 1083248504
Nurse Practitioner - Gerontology in Portland, OR

Q: 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.

Q: What is Maryam Saudagaran's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: 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.

Active since February 24, 2020PECOS EnrolledAccepts Medicare Assignment

6350 NE HALSEY ST, PORTLAND, OR 97213(503) 215-2669 Get Directions Write a Review

NPPES record last updated: November 2, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 2, 2023, Sep 21, 2022, Feb 14, 2021 and 2 more (5 updates tracked since 2020).

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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 is a graduate of Other (2022).

NPPES Registry Identity

NPI1083248504

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameMARYAM SAUDAGARANCredential: AGPCNP

Location Address6350 NE HALSEY STPortland, OR 97213-4720

Mailing AddressPo Box 3158Portland, OR 97208-3158 · (503) 215-6494

Phone(503) 215-2669

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateFebruary 24, 2020

Last NPPES UpdateNovember 2, 20235 updates tracked since enumeration

NPPES CertifiedNovember 2, 2023

✔ NPI 1083248504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

Licenses✔ Licensed in OR · 10008586✔ Licensed in WA · AP61297081

Also ListedRegistered NurseTaxonomy 163W00000X · License RN60976395 (WA)

Also ListedNurse PractitionerTaxonomy 363L00000X · License AP61297081 (WA)

6350 NE HALSEY ST, Portland, OR 97213

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Other Identifiers 1

Medicaid2209323WA

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

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.

PECOS PAC ID8729466776

PECOS Enrollment IDI20230825001975

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.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

67 services62 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

45 services26 patients

Hospital Affiliations CMS Care Compare 2

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, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380004

Location9205 SW Barnes RoadPortland, OR 97225 · Washington County

Emergency services Birthing friendly

Providence Willamette Falls Medical Center

Acute Care Hospitals · Oregon City, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380038

Location1500 Division StreetOregon City, OR 97045 · Clackamas County

Emergency services Birthing friendly

Physician 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.

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

$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 10

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

RICHARD T WARREN ANP

Nurse Practitioner (Adult Health)