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

Q: 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.

Q: What is Gwen Sampson's specialty?

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

Q: 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.

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: August 02, 2026.

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

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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, and ordering and referring status from the CMS PECOS system.

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.

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.

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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