NPIMap

Organization Active NPI

Good Samaritan Hospital Corvallis

Doing business as Good Samaritan Regional Medical Center Breast & Surgical Oncology

  • Clinic/Center
  • Corvallis, OR
National Provider Identifier
1376164129
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
GOOD SAMARITAN HOSPITAL CORVALLIS
Doing business as
Good Samaritan Regional Medical Center Breast & Surgical Oncology
Practice address
441 NW Elks Dr Ste 101
Corvallis, OR 97330-3744
Phone
(541) 768-1252
NPI assigned
May 4, 2020
Last updated
Jul 31, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
GOOD SAMARITAN HOSPITAL CORVALLISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Joseph M Cahill III
Title
Ceo-Gsrmc
Phone
(541) 768-7914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

441 NW Elks Dr Ste 101
Corvallis, OR 97330-3744

Mailing address

PO Box 1189
Corvallis, OR 97339-1189
Phone (541) 768-4410

Other names 1

  • Good Samaritan Regional Medical Center Breast & Surgical Oncology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376164129. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Dec 8, 1948 in OR
Enrollment address
3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Main/Primary Hospital Location
Hospital subgroups
General

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

Care Compare: Hospital

Medicare Care Compare
Listed as
Good Samaritan Regional Medical CenterCCN 380014 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Samaritan OB-GYN

Locations

501 NW Elks Dr
Ste 101
Corvallis, OR 97330
Phone (541) 768-1252

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Samaritan Health Services Inc. Organization, Corvallis, OR Corporation, Non-profit, Chain home office Operational/Managerial Control Dec 17, 1992 100%
Abbe E Montgomery Individual Corporate DirectorBoard Member Jan 1, 2021
Becky Pape Individual Corporate DirectorBoard Member Jan 1, 2025
Joseph Cahill Individual Corporate OfficerCeo Aug 1, 2024
W-2 Managing EmployeeCeo Aug 1, 2024
Nancy Seifert Individual Corporate OfficerChair Nov 2, 2010
Corporate DirectorBoard Member Nov 2, 2010
Kelly Gallagher Individual Corporate DirectorSecretary Apr 23, 2018
Lyle Hutchens Individual Corporate DirectorBoard Member Jan 1, 2016
Richard Cronk Individual Corporate OfficerTreasurer Jan 1, 1998
Corporate DirectorBoard Member Jan 1, 1998
Tim Hennessy Individual Corporate DirectorBoard Member Nov 2, 2011
Steve Uerlings Individual Corporate DirectorBoard Member Apr 23, 2013
Josiah S Johnson Individual Corporate OfficerCeo-Gsrmc Dec 2, 2024
W-2 Managing EmployeeCeo-Gsrmc Dec 2, 2024
Operational/Managerial ControlCeo-Gsrmc Dec 2, 2024
Eric Thompson Individual Corporate DirectorBoard Member Jan 1, 2001
Surinder M Vasdev Individual Corporate DirectorBoard Member Aug 20, 2024
David Marshall Individual Corporate DirectorBoard Member Aug 1, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

Affiliated clinicians 617

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 617

NPI Registry JSON

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1376164129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189",
            "telephone_number": "541-768-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 NW ELKS DR STE 101",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303744",
            "telephone_number": "541-768-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL CORVALLIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOOD SAMARITAN HOSPITAL CORVALLIS",
        "enumeration_date": "2020-05-04",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "CAHILL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO-GSRMC",
        "authorized_official_telephone_number": "541-768-7914",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Regional Medical Center Breast & Surgical Oncology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.