Individual provider Active NPI

Summer Morgan Massina, ARNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1003303165
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202213854NP-PP Issued in OR
Practice address
721 NW 9TH Ave Ste 100
Portland, OR 97209-3519
Phone
(503) 525-0090
NPI assigned
Apr 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A134262 IA
Family Nurse Practitioner 363LF0000X 202213854NP-PP OR Primary

Addresses

Primary practice location

721 NW 9TH Ave Ste 100
Portland, OR 97209-3519

Mailing address

2710 Saint Francis Dr
Waterloo, IA 50702-5619
Phone (319) 272-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230222001242 OR Practitioner - Nurse Practitioner 8729343447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pearl Health Center PCGroup PAC ID 0143287243, 7 clinicians

Practice addresses (Care Compare)

721 NW 9TH Ave
Suite 100
Portland, OR 97209-3519
Phone (503) 525-0090

Hospital & facility affiliations

  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
202213854NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pearl Health Center,PC CurrentSince Dec 19, 2022 Accepting new patients

Locations

721 NW 9th Ave
Ste 100
Portland, OR 97209
Phone (503) 345-9339

933 NW 25th Ave
Portland, OR 97210
Phone (503) 221-1870

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1003303165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 SAINT FRANCIS DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025619",
            "telephone_number": "319-272-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 NW 9TH AVE STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093519",
            "telephone_number": "503-525-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSINA",
        "first_name": "SUMMER",
        "middle_name": "MORGAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-15",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A134262",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202213854NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.