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SAMUEL MOODY PA-C
NPI 1710655584
Physician Assistant - Medical in Portland, OR

Active since September 05, 2021PECOS EnrolledAccepts Medicare Assignment
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 494-6596(503) 494-4285 Get Directions Write a Review

NPPES record last updated: January 9, 2024. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Samuel Moody Pa-c NPPES

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

SAMUEL MOODY PA-C (NPI 1710655584) is an individual medical provider in Portland, Oregon, licensed in Oregon (PA217671) and active in the NPI registry since September 2021. He is enrolled in Medicare PECOS, is affiliated with Ohsu Hospital And Clinics, and is a graduate of Oregon Health Sciences University School Of Medicine (2023).

NPPES Registry Identity

NPI1710655584
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameSAMUEL MOODYCredential: PA-C
Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3011
Mailing Address1400 Sw 5th Ave Ste 500Portland, OR 97201-5537 · (866) 617-6855 · Fax (503) 346-8015
Phone(503) 494-6596
Fax(503) 494-4285
Sole ProprietorNo
Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2023
Enumeration DateSeptember 5, 2021
Last NPPES UpdateJanuary 9, 2024
NPPES CertifiedJanuary 9, 2024
✔ NPI 1710655584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in OR · PA217671
3181 SW SAM JACKSON PARK RD, Portland, OR 97239
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samuel Moody Pa-c 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.

PECOS PAC ID7214385749
PECOS Enrollment IDI20231122000915
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.

Areas of Expertise CMS Part B claims

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.

Biopsy and aspiration of bone marrow sample for diagnosis 38222
A bone marrow biopsy and aspiration is a procedure where a small amount of bone marrow is removed for testing. It involves inserting a needle into a bone, typically the hip, to collect a sample. It can help diagnose various diseases and monitor treatment effectiveness.
27 services26 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ohsu Hospital And Clinics

Acute Care Hospitals · Portland, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number380009
Location3181 SW Sam Jackson Park RoadPortland, OR 97239 · Multnomah County
Emergency services Birthing friendly

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.

DONALD RICHARD SULLIVAN MD
Internal Medicine (Pulmonary Disease)
3181 SW SAM JACKSON PARK RD, UHN67
PORTLAND, OR 97239
Multnomah County (503) 494-6949
MRS. ANJALEE NIX ROWE NP
Nurse Practitioner (Acute Care)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-3988
REEM HASAN MD
Internal Medicine
3181 SW SAM JACKSON PARK RD, PPV 350
PORTLAND, OR 97239
Multnomah County (503) 494-8562
DR. AMANDA D BALL PSY.D
Psychologist (Clinical)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
SUNSHINE WELSCH LMT
Massage Therapist
3181 SW SAM JACKSON PARK RD, 7D19
PORTLAND, OR 97239
Multnomah County (503) 494-8349
DR. ROBERT GENE MEALER M.D., PH.D.
Psychiatry & Neurology (Psychiatry)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
GREGORY HALL MD
Radiology (Diagnostic Radiology)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 418-0990
DR. BURHAN AHMED MIAN MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-8311

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 Moody's NPI number?

The NPI number for Samuel Moody is 1710655584. It was assigned to this individual provider in the NPPES registry on September 5, 2021.

Where is Samuel Moody located?

Samuel Moody practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-6596.

What is Samuel Moody's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Samuel Moody enrolled in Medicare?

Yes. Samuel Moody 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.

What insurance does Samuel Moody accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Samuel Moody as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Samuel Moody affiliated with any hospitals?

According to CMS data, Samuel Moody is affiliated with Ohsu Hospital And Clinics.

When was this NPI record last updated?

The NPPES record for Samuel Moody was last updated on January 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.