SAMUEL KIMBALL BOOTH DO
NPI 1972208700
Internal Medicine in Portland, OR
About Samuel Kimball Booth Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL KIMBALL BOOTH DO (NPI 1972208700) is an individual internal medicine provider in Portland, Oregon, licensed in Oregon (DO230368) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS and is a graduate of University Of New England, College Of Osteo Medicine (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Samuel Kimball Booth Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Samuel Booth reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Portland, OR 97225
- 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97225 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORTLAND, OR 97225
PORTLAND, OR 97225
PORTLAND, OR 97225
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 Booth's NPI number?
The NPI number for Samuel Booth is 1972208700. It was assigned to this individual provider in the NPPES registry on April 3, 2023.
Where is Samuel Booth located?
Samuel Booth practices at 9205 SW Barnes Rd, Portland, OR 97225. The listed phone number is (503) 216-2906.
What is Samuel Booth's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Samuel Booth enrolled in Medicare?
Yes. Samuel Booth is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Samuel Booth's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Booth reassigns Medicare benefits to Providence Health & Services Oregon (Portland, 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 Samuel Booth'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 Samuel Booth was last updated on July 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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 Kimball Booth, DO · NPI 1972208700
Internal Medicine physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since April 3, 2023.
## Identity
- **NPI:** 1972208700 (Entity type: Individual)
- **Enumerated:** April 3, 2023
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** DO230368 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 9205 SW BARNES RD, Portland, OR 97225-6603
- **Phone:** (503) 216-2906
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Providence Health & Services Oregon (NPI 1053403394, Portland, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of New England, College Of Osteo Medicine, class of 2023
## Record status
- **NPPES last updated:** July 28, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1972208700) · Data from the CMS NPPES public registry.