SAMUEL MILES GROVENBURG M.D.
NPI 1548624166
Internal Medicine in Portland, OR
About Samuel Miles Grovenburg M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL MILES GROVENBURG M.D. (NPI 1548624166) is an individual internal medicine provider in Portland, Oregon, licensed in Oregon (MD189434) and active in the NPI registry since April 2016. He 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 2
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
Samuel Miles Grovenburg M.d. 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
2Medicare enrollment records show Samuel Grovenburg reassigns Medicare billing to 2 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
- 676 clinicians in this Medicare group
Portland, OR 97213
- Reassigned Medicare billing, Oregon enrollment
- 1,501 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 4
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 4
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 Newberg Medical Center
Acute Care Hospitals · Newberg, ORProvidence Willamette Falls Medical Center
Acute Care Hospitals · Oregon City, ORProvidence Portland Medical Center
Acute Care Hospitals · Portland, 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.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Referred Medical Equipment & Supplies CMS DME claims 3
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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 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 Samuel Grovenburg's NPI number?
The NPI number for Samuel Grovenburg is 1548624166. It was assigned to this individual provider in the NPPES registry on April 9, 2016.
Where is Samuel Grovenburg located?
Samuel Grovenburg practices at 4805 NE Glisan St, Portland, OR 97213. The listed phone number is (503) 215-2392.
What is Samuel Grovenburg's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Samuel Grovenburg enrolled in Medicare?
Yes. Samuel Grovenburg 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 Samuel Grovenburg's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Grovenburg reassigns Medicare benefits to 2 organizations: 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 Samuel Grovenburg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Samuel Grovenburg affiliated with any hospitals?
According to CMS data, Samuel Grovenburg is affiliated with Providence St Vincent Medical Center, Providence Newberg Medical Center, Providence Willamette Falls Medical Center and Providence Portland Medical Center.
When was this NPI record last updated?
The NPPES record for Samuel Grovenburg was last updated on March 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Samuel Miles Grovenburg, M.D. · NPI 1548624166
Internal Medicine physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since April 9, 2016.
## Identity
- **NPI:** 1548624166 (Entity type: Individual)
- **Enumerated:** April 9, 2016
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** MD189434 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 4805 NE GLISAN ST, Portland, OR 97213
- **Phone:** (503) 215-2392
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Providence Health & Services - Oregon (NPI 1003991845, Portland, OR); Providence Health & Services - Oregon (NPI 1316197692, Portland, OR) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Tulane University School Of Medicine, class of 2016
## Record status
- **NPPES last updated:** March 10, 2021
- **Other identifiers:** Medicaid 500709428 (OR)
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Source: [NPI Profile](https://npiprofile.com/npi/1548624166) · Data from the CMS NPPES public registry.