MAXWELL LEE SUMMERLIN
NPI 1417533886
Medical Genetics - Clinical Genetics (M.D.) in Portland, OR
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 and is a graduate of George Washington University School Of Medicine (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Maxwell Lee Summerlin is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Maxwell Summerlin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Portland, OR 97239
- Reassigned Medicare billing, Oregon enrollment
- 2,212 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.
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.
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
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.
Which organization bills Medicare for Maxwell Summerlin's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Maxwell Summerlin reassigns Medicare benefits to University Professional Services (Portland, OR). The 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 Maxwell Summerlin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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 5 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.
# Maxwell Lee Summerlin · NPI 1417533886
Clinical Genetics (M.D.) physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since March 24, 2021.
## Identity
- **NPI:** 1417533886 (Entity type: Individual)
- **Enumerated:** March 24, 2021
- **Primary specialty:** Medical Genetics - Clinical Genetics (M.D.) · taxonomy 207SG0201X
- **State license:** 2025197 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 3181 SW SAM JACKSON PARK RD, Portland, OR 97239-3011
- **Phone:** (503) 494-8311
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** University Professional Services (NPI 1376709535, Portland, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** George Washington University School Of Medicine, class of 2021
## Record status
- **NPPES last updated:** April 30, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1417533886) · Data from the CMS NPPES public registry.