Legacy Good Samaritan Hospital and Medical Center

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RP-0001427-CS Issued in OR

Legal business name

LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER

Practice address

1040 NW 22ND Ave
Suite 100
Portland, OR 97210-3057

Phone

(503) 413-8122

NPI assigned

Jul 20, 2006

Organization subpart

Yes

Parent organization

LEGACY GOOD SAMARITAN HOSPITAL AND MEDICALAs reported in NPPES

Name

Sarah Jensen

Title

VP Finance

Phone

(503) 415-5145

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Legacy Good Samaritan Hospital and Medical Center

  • Clinic/Center
  • Portland, OR
  • NPI 1679597108

  0547179939

  Same PAC ID
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216

  0547179939

  Same PAC ID
• Legacy Good Samaritan Hospital and Medical Center

  • Rehabilitation Hospital Unit
  • Portland, OR
  • NPI 1942223482

  0547179939

  Same PAC ID

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas James Abbott, M.D.

  • Cardiovascular Disease Physician
  • Tualatin, OR
  • NPI 1124319330
  Care Compare group NPD
• Blake Vance Acohido, M.D.

  • Ophthalmology Physician
  • Portland, OR
  • NPI 1518100734
  Care Compare group NPD
• Merrill Marshall Ahrens, MD

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1194839225
  Care Compare group NPD
• Elizabeth Ann Alston

  • Family Nurse Practitioner
  • Portland, OR
  • NPI 1205348539
  Care Compare group NPD
• George A Anadiotis, DO

  • Ph.D. Medical Genetics Physician
  • Portland, OR
  • NPI 1992766695
  Care Compare group NPD
• Jennifer R Antick, PHD

  • Clinical Psychologist
  • Portland, OR
  • NPI 1285626507
  Care Compare group NPD
• Moses Azubuike, M.D

  • Vascular & Interventional Radiology Physician
  • Portland, OR
  • NPI 1700232105
  Care Compare group NPD
• Aman Bagla, D.O.

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1467771188
  Care Compare group NPD
• Lisa A Bailey, P.A.-C

  • Surgical Physician Assistant
  • Portland, OR
  • NPI 1528074846
  Care Compare group NPD
• Erica T Ballard

  • Medical Physician Assistant
  • Portland, OR
  • NPI 1932542503
  Care Compare group NPD
• Megan Barckert

  • Family Nurse Practitioner
  • Portland, OR
  • NPI 1649348160
  Care Compare group NPD
• Adam Randall Bartling, PA-C

  • Physician Assistant
  • Gresham, OR
  • NPI 1427550367
  Care Compare group NPD

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Part of

Legacy Good Samaritan CNTR

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 20, 2026.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1609896174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-413-4048",
            "fax_number": "503-413-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103057",
            "telephone_number": "503-413-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL",
        "enumeration_date": "2006-07-20",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "503-415-5145"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "RP-0001427-CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3806051",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Legacy Emanuel Hospital and Health Center
• Legacy Emanuel Hospital and Health Center
• Legacy Good Samaritan Hospital and Medical Center
• Legacy Good Samaritan Hospital and Medical Center
• Legacy Good Samaritan Hospital and Medical Center
• Legacy Good Samaritan Hospital and Medical Center
• Legacy Good Samaritan Hospital and Medical Center
• Legacy Good Samaritan Hospital and Medical Center
• Legacy Health
• Legacy Health System

• All providers in Portland, OR
• Community/Retail Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.