TIMOTHY SAMUEL WADDELL FNP
NPI 1629878467
Nurse Practitioner - Family in Portland, OR
About Timothy Samuel Waddell Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIMOTHY SAMUEL WADDELL FNP (NPI 1629878467) is an individual family provider in Portland, Oregon, licensed in Oregon (10064849) and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses 2
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
Timothy Samuel Waddell Fnp 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 Timothy Waddell reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Crescent City, CA 95531
- Reassigned Medicare billing, California enrollment
- 2,323 clinicians in this Medicare group
Bakersfield, CA 93312
- Reassigned Medicare billing, California enrollment
- 225 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97209 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Timothy Waddell's NPI number?
The NPI number for Timothy Waddell is 1629878467. It was assigned to this individual provider in the NPPES registry on March 18, 2025.
Where is Timothy Waddell located?
Timothy Waddell practices at 923 NW 14th Ave, Portland, OR 97209. The listed phone number is (503) 972-0235.
What is Timothy Waddell's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Timothy Waddell enrolled in Medicare?
Yes. Timothy Waddell 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 Timothy Waddell's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Waddell reassigns Medicare benefits to 2 organizations: Cep America-California (Crescent City, CA) and Emergency Physicians Urgent Care Inc. (Bakersfield, CA). 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 Timothy Waddell'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 Timothy Waddell was last updated on September 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 49 days 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.
# Timothy Samuel Waddell, FNP · NPI 1629878467
Family physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since March 18, 2025.
## Identity
- **NPI:** 1629878467 (Entity type: Individual)
- **Enumerated:** March 18, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 10064849 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 923 NW 14TH AVE, Portland, OR 97209-2704
- **Phone:** (503) 972-0235 · **Fax:** (503) 379-1523
## 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): Cep America-California (NPI 1366124364, Crescent City, CA); Emergency Physicians Urgent Care Inc. (NPI 1689963845, Bakersfield, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** September 8, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1629878467) · Data from the CMS NPPES public registry.