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GWEN SAMPSON
NPI 1558812867
Nurse Practitioner - Gerontology in Beaverton, OR

Active since October 21, 2016PECOS Enrolled
6800 SW 105TH AVE STE 206, BEAVERTON, OR 97008(503) 430-1777(503) 372-5119 Get Directions Write a Review

NPPES record last updated: April 6, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 6, 2023, Oct 21, 2016 (2 updates tracked since 2016).

About Gwen Sampson NPPES

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

GWEN SAMPSON (NPI 1558812867) is an individual gerontology provider in Beaverton, Oregon, licensed in Oregon (201703018NP-PP) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558812867
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameGWEN SAMPSON
Location Address6800 SW 105TH AVE STE 206Beaverton, OR 97008-5487
Mailing Address6800 Sw 105th Ave Ste 206Beaverton, OR 97008-5487 · (503) 430-1777 · Fax (503) 372-5119
Phone(503) 430-1777
Fax(503) 372-5119
Sole ProprietorNo
Enumeration DateOctober 21, 2016
Last NPPES UpdateApril 6, 20232 updates tracked since enumeration
NPPES CertifiedApril 6, 2023
✔ NPI 1558812867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
Licenses✔ Licensed in OR · 201703018NP-PP✔ Licensed in NJ · 26NJ00678600
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 26NJ00678600 (NJ)
6800 SW 105TH AVE STE 206, Beaverton, OR 97008
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gwen Sampson 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.

Medicare Billing Reassignment

Medicare enrollment records show Gwen Sampson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Crm Physicians, LLC
Same address
Internal Medicine
6800 SW 105TH AVE STE 206
Beaverton, OR 97008
  • Reassigned Medicare billing, Oregon enrollment
  • 84 clinicians in this Medicare group
NPI 1952674996 (503) 351-3505

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97008 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 20

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

KIERSTEN SPERRY PA-C
Physician Assistant
6800 SW 105TH AVE STE 206
BEAVERTON, OR 97008
Washington County (503) 430-1777
CORNELIU VOLOSEN ARNP
Nurse Practitioner
6800 SW 105TH AVE STE 206
BEAVERTON, OR 97008
Washington County (503) 430-1777
MRS. SARAH ELIZABETH DUNHAM MD
Internal Medicine
6800 SW 105TH AVE STE 206
BEAVERTON, OR 97008
Washington County (503) 430-1777
MS. JULIE LYN CRAMER PA-C
Physician Assistant
6800 SW 105TH AVE STE 206
BEAVERTON, OR 97008
Washington County (503) 430-1777
JOEL K. YERBO APRN.CNP
Nurse Practitioner
6800 SW 105TH AVE STE 206
BEAVERTON, OR 97008
Washington County (035) 430-1777
BENJAMIN WUN SING YOUNG PA-C
Physician Assistant
6800 SW 105TH AVE STE 206
BEAVERTON, OR 97008
Washington County (503) 430-1777
JORDAN NADINE DENNY AUL
Physician Assistant
6800 SW 105TH AVE STE 206
BEAVERTON, OR 97008
Washington County (503) 430-1777
DR. BRIDGET ELIZABETH SCIBETTA DNP, AGPCNP-BC
Nurse Practitioner
6800 SW 105TH AVE STE 206
BEAVERTON, OR 97008
Washington County (503) 430-1777

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 Gwen Sampson's NPI number?

The NPI number for Gwen Sampson is 1558812867. It was assigned to this individual provider in the NPPES registry on October 21, 2016.

Where is Gwen Sampson located?

Gwen Sampson practices at 6800 SW 105th Ave Ste 206, Beaverton, OR 97008. The listed phone number is (503) 430-1777.

What is Gwen Sampson's specialty?

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

Is Gwen Sampson enrolled in Medicare?

Yes. Gwen Sampson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Gwen Sampson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gwen Sampson reassigns Medicare benefits to Crm Physicians, LLC (Beaverton, 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 Gwen Sampson'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 Gwen Sampson was last updated on April 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.