NPIMap

Individual provider Active NPI

Elizabeth Reyes Sammond, M.D.

  • Internal Medicine Physician
  • Tualatin, OR
National Provider Identifier
1437127347
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD23914 Issued in OR
Practice address
19875 SW 65TH Ave Ste 100
Tualatin, OR 97062-8353
Phone
(503) 692-7785
Fax
(503) 885-1663
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD23914 OR Primary

Addresses

Primary practice location

19875 SW 65TH Ave Ste 100
Tualatin, OR 97062-8353

Mailing address

19875 SW 65TH Ave Ste 100
Tualatin, OR 97062-8353
Phone (503) 692-7785

Other identifiers 1

IdentifierTypeStateIssuer
286576MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040408000164 OR Practitioner - Internal Medicine 8820081334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Davis School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Meridian Park HospitalGroup PAC ID 5092609842, 113 clinicians

Practice addresses (Care Compare)

19300 SW 65TH Ave
Tualatin, OR 97062-7706
Phone (503) 413-4330

19875 SW 65TH Ave
Tualatin, OR 97062-8353
Phone (503) 692-7785

Hospital & facility affiliations

  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD23914ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Meridian Park Hospital CurrentSince Apr 1, 2012 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Dec 1, 2003 Accepting new patients
Legacy Clinics LLC CurrentSince Dec 1, 2003 Accepting new patients
Legacy Meridian Park Hospital Past Accepting new patients
Legacy Meridian Park Pediatric Rehab Past Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

19875 SW 65th Ave
Ste 100
Tualatin, OR 97062
Phone (503) 692-7785

1002 N Boones Ferry Rd
Woodburn, OR 97071
Phone (503) 981-9526

Interoperability endpoints

  • Direct secure messaging: esammond11808@direct.lhs.org

Organizations & group practices 5

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 6

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437127347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19875 SW 65TH AVE STE 100",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628353",
            "telephone_number": "503-692-7785",
            "fax_number": "503-885-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19875 SW 65TH AVE STE 100",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628353",
            "telephone_number": "503-692-7785",
            "fax_number": "503-885-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMOND",
        "first_name": "ELIZABETH",
        "middle_name": "REYES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD23914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286576",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

Verify at the official NPI Registry.