NPIMap

Individual provider Active NPI

Scott G Sims, PA-C

  • Surgical Physician Assistant
  • Corvallis, OR
National Provider Identifier
1497925135
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA179815 Issued in OR
Practice address
3640 NW Samaritan Dr Ste 120
Corvallis, OR 97330-3738
Phone
(541) 768-5223
NPI assigned
Mar 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 002083 CT
Surgical Physician Assistant 363AS0400X 0110002857 VA
Surgical Physician Assistant 363AS0400X 3418 CO
Surgical Physician Assistant 363AS0400X PA179815 OR Primary

Addresses

Primary practice location

3640 NW Samaritan Dr Ste 120
Corvallis, OR 97330-3738

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

3600 NW Samaritan Dr
Suite 227
Corvallis, OR 97330-3737
Phone (541) 768-5223

Other identifiers 1

IdentifierTypeStateIssuer
1497925135MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssims132155@samhealth.direct-ci.com

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
I20170106001819 OR Practitioner - Physician Assistant 9436219268 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Hospital CorvallisGroup PAC ID 1557270725, 372 clinicians

Practice addresses (Care Compare)

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
75.94
Promoting interoperability
100
Improvement activities
40
Cost
83.56

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
85.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3418COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Corvallis CurrentSince Aug 4, 2024 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Nov 28, 2016 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Nov 28, 2016 Accepting new patients
Salem Health CurrentSince May 13, 2024 Accepting new patients
Salem Health CurrentSince May 13, 2024 Accepting new patients

Locations

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

Interoperability endpoints

  • Direct secure messaging: ssims389889@direct.salemhealth.org
  • Direct secure messaging: simss062@yourcarecommunity.org

Organizations & group practices 8

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1497925135",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 NW SAMARITAN DR STE 120",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303738",
            "telephone_number": "541-768-5223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_2": "Suite 227",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303737",
            "country_code": "US",
            "telephone_number": "541-768-5223",
            "fax_number": "541-768-5014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMS",
        "first_name": "SCOTT",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-10",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "002083",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110002857",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "3418",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA179815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497925135",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssims132155@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3640 NW Samaritan Dr Ste 120",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.