MAXWELL LEE SUMMERLIN
NPI 1417533886
Medical Genetics - Clinical Genetics (M.D.) in Portland, OR

Active since March 24, 2021PECOS Enrolled
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 494-8311 Get Directions Write a Review

NPPES record last updated: April 30, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 30, 2026, Mar 24, 2021 (2 updates tracked since 2021).

About Maxwell Lee Summerlin NPPES

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

MAXWELL LEE SUMMERLIN (NPI 1417533886) is an individual clinical genetics (m.d.) provider in Portland, Oregon, licensed in Oregon (2025197) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417533886
Entity TypeIndividualMale
Primary Taxonomy207SG0201X
Provider Legal NameMAXWELL LEE SUMMERLIN
Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3011
Mailing Address3181 Sw Sam Jackson Park RdPortland, OR 97239-3011
Sole ProprietorNo
Enumeration DateMarch 24, 2021
Last NPPES UpdateApril 30, 20262 updates tracked since enumeration
NPPES CertifiedApril 30, 2026
NPI 1417533886 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyMedical Genetics · Clinical Genetics (M.D.)Allopathic & Osteopathic Physicians
Taxonomy Code207SG0201X
License Licensed in OR · 2025197
Definition
A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders.
3181 SW SAM JACKSON PARK RD, Portland, OR 97239

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Maxwell Lee Summerlin 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.

Internal Medicine (Pulmonary Disease)
3181 SW SAM JACKSON PARK RD, UHN67
PORTLAND, OR 97239
Nurse Practitioner (Acute Care)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Internal Medicine
3181 SW SAM JACKSON PARK RD, PPV 350
PORTLAND, OR 97239
Psychologist (Clinical)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Massage Therapist
3181 SW SAM JACKSON PARK RD, 7D19
PORTLAND, OR 97239
Psychiatry & Neurology (Psychiatry)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Radiology (Diagnostic Radiology)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239

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 Maxwell Summerlin's NPI number?

The NPI number for Maxwell Summerlin is 1417533886. It was assigned to this individual provider in the NPPES registry on March 24, 2021.

Where is Maxwell Summerlin located?

Maxwell Summerlin practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-8311.

What is Maxwell Summerlin's specialty?

The primary specialty registered for this NPI is Medical Genetics, specializing in Clinical Genetics (M.D.), with taxonomy code 207SG0201X.

Is Maxwell Summerlin enrolled in Medicare?

Yes. Maxwell Summerlin is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Maxwell Summerlin was last updated on April 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.