Good Samaritan Hospital Corvallis
Organization Active NPI Urology Physician · Corvallis, OR
NPI 1235409236 · NPPES record last updated Jul 31, 2024
Key facts
- NPI
- 1235409236
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urology Physician 208800000X
- License
- 14-1074-1 (OR)
- Legal business name
- GOOD SAMARITAN HOSPITAL CORVALLIS
- Practice address
- 990 NW Circle Blvd Suite 102
Corvallis, OR 97330-1967 - Phone
- (541) 768-5486
- Fax
- (541) 768-5484
- NPI assigned
- Jan 6, 2012
- Organization subpart
- No
Authorized official
- Name
- Joseph M Cahill III
- Title
- Ceo-Gsrmc
- Phone
- (541) 768-7914
Owners & managing parties with NPI records 2
Other NPIs on the same Medicare enrollment 20
Corporate family (same tax ID) 49
Related certifications (CCN) 1
Practitioners 14
-
Alexandra Bernal, PHD
-
Michael P Cruise, PA-C
-
Brent Didier, DO
-
Michelle Lee Jones, APRN CNP
-
Jentry B Lloyd, D.O.
-
Kindra T. Newhart, PA-C
-
Lisa Jane Sabally, CNM
-
Rachel J Shirley, D.O.
-
Karla J Snyder, CNM
-
Daniel E Stenger, PHYSICIAN ASSISTANT
Affiliated clinicians 617
-
Aamir Abbas, DO
-
Mary Abraham, MD
-
Bryce Andrew Allio, M.D.
-
Holly T Almond, NP
-
Christopher Lee Amling, M.D., F.A.C.S.
-
Brian Andrew, PA-C
-
Tim Arakawa, MD, PHD
-
Lisa Rene Araneta, PA-C
-
Leslie Ann Arpin, M.D.
-
Brian D Ashdown, DPM
-
Abinet Ashine, M.D.
-
Hannah Rasma Balduff, PA-C
-
William G. Barish, M.D.
-
Scott J. Barlow, PA-C
-
Kristina Barnes, DO
-
Daniel P Barrett, M.D.
Medicare Care Compare: Hospital
- Listed as
- Good Samaritan Regional Medical Center
- Overall star rating
- ★★★☆☆ 3 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D2003753 | Samaritan Urology-Corvallis | Certificate of waiver | Mar 22, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OR
Hospital certification: CCN 380014
- Legal name
- GOOD SAMARITAN HOSPITAL CORVALLIS
- Doing business as
- GOOD SAMARITAN REGIONAL MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Jan 13, 2016
- Beds
- 188
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Dec 8, 1948 in OR
- Enrollment address
- 3600 NW Samaritan Dr
Corvallis, OR 97330-3737 - Hospital subgroups
- General
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Samaritan Health Services Inc. |
Operational/Managerial Control | Dec 17, 1992 | 100% |
| Abbe E Montgomery |
Corporate Director |
Jan 1, 2021 | |
| Becky Pape |
Corporate Director |
Jan 1, 2025 | |
| Joseph Cahill |
Corporate Officer |
Aug 1, 2024 | |
| W-2 Managing Employee |
Aug 1, 2024 | ||
| Nancy Seifert |
Corporate Officer |
Nov 2, 2010 | |
| Corporate Director |
Nov 2, 2010 | ||
| Kelly Gallagher |
Corporate Director |
Apr 23, 2018 | |
| Lyle Hutchens |
Corporate Director |
Jan 1, 2016 | |
| Richard Cronk |
Corporate Officer |
Jan 1, 1998 | |
| Corporate Director |
Jan 1, 1998 | ||
| Tim Hennessy |
Corporate Director |
Nov 2, 2011 | |
| Steve Uerlings |
Corporate Director |
Apr 23, 2013 | |
| Josiah S Johnson |
Corporate Officer |
Dec 2, 2024 | |
| W-2 Managing Employee |
Dec 2, 2024 | ||
| Operational/Managerial Control |
Dec 2, 2024 | ||
| Eric Thompson |
Corporate Director |
Jan 1, 2001 | |
| Surinder M Vasdev |
Corporate Director |
Aug 20, 2024 | |
| David Marshall |
Corporate Director |
Aug 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030319000024 | OR | Part a Provider - Hospital | 1557270725 |
20 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Corvallis, OR |
| O20031125000163 | OR | Part B Supplier - Clinic/Group Practice | 1557270725 |
Receives reassigned benefits from 589 practitioners This NPI is an additional NPI on the enrollment Practice locations: Corvallis, OR; Albany, OR |
National Provider Directory
- Tax ID family
- Good Samaritan Regional Med
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician |
208800000X | 14-1074-1 | OR | Yes |
Addresses
Primary practice location
990 NW Circle Blvd Suite 102
Corvallis, OR 97330-1967
Mailing address
PO Box 1189
Corvallis, OR 97339-1189
Phone (541) 768-6768
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500651453 | Medicaid | OR |
Other names
- Samaritan Urology - Corvallis
Other providers in Corvallis, OR
- Good Samaritan Hospital Corvallis
- Good Samaritan Hospital Corvallis
- Good Samaritan Hospital Corvallis
- Good Samaritan Hospital Corvallis
- Good Samaritan Hospital Corvallis
- Good Samaritan Hospital Corvallis
- Good Samaritan Hospital Corvallis
- Good Samaritan Hospital Corvallis
- Good Samaritan Hospital Corvallis
- Good Samaritan Hospital Corvallis
All providers in Corvallis, OR · Urology Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.