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SAMANTHA WELLER
NPI 1093404477
Student in an Organized Health Care Education/Training Program in Portland, OR

Active since May 02, 2023PECOS Enrolled
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 494-8211 Get Directions Write a Review

NPPES record last updated: July 25, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 25, 2023, May 2, 2023 (2 updates tracked since 2023).

About Samantha Weller NPPES

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

SAMANTHA WELLER (NPI 1093404477) is an individual student in an organized health care education/training program in Portland, Oregon, licensed in Oregon (PG216051) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1093404477
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSAMANTHA WELLER
Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3011
Mailing Address3181 Sw Sam Jackson Park RdPortland, OR 97239-3011 · (503) 494-8211
Phone(503) 494-8211
Sole ProprietorNo
Enumeration DateMay 2, 2023
Last NPPES UpdateJuly 25, 20232 updates tracked since enumeration
NPPES CertifiedJuly 25, 2023
✔ NPI 1093404477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in OR · PG216051
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3181 SW SAM JACKSON PARK RD, Portland, OR 97239
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Secondary Practice Location 1

Location 1727 W Burnside StPortland, OR 97209-3514 · Phone (503) 228-4533

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Weller is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

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

DONALD RICHARD SULLIVAN MD
Internal Medicine (Pulmonary Disease)
3181 SW SAM JACKSON PARK RD, UHN67
PORTLAND, OR 97239
Multnomah County (503) 494-6949
MRS. ANJALEE NIX ROWE NP
Nurse Practitioner (Acute Care)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-3988
REEM HASAN MD
Internal Medicine
3181 SW SAM JACKSON PARK RD, PPV 350
PORTLAND, OR 97239
Multnomah County (503) 494-8562
DR. AMANDA D BALL PSY.D
Psychologist (Clinical)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
SUNSHINE WELSCH LMT
Massage Therapist
3181 SW SAM JACKSON PARK RD, 7D19
PORTLAND, OR 97239
Multnomah County (503) 494-8349
DR. ROBERT GENE MEALER M.D., PH.D.
Psychiatry & Neurology (Psychiatry)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
GREGORY HALL MD
Radiology (Diagnostic Radiology)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 418-0990
DR. BURHAN AHMED MIAN MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-8311

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 Samantha Weller's NPI number?

The NPI number for Samantha Weller is 1093404477. It was assigned to this individual provider in the NPPES registry on May 2, 2023.

Where is Samantha Weller located?

Samantha Weller practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-8211.

What is Samantha Weller's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Samantha Weller enrolled in Medicare?

Yes. Samantha Weller is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Samantha Weller was last updated on July 25, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.