NPIMap

Individual provider Active NPI

Samantha Rao Shah, MD

  • Internal Medicine Physician
  • Corvallis, OR
National Provider Identifier
1659355899
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD173772 Issued in OR
Practice address
3521 NW Samaritan Dr Ste 201
Corvallis, OR 97330-4744
Phone
(541) 768-5140
NPI assigned
Dec 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD424815 PA
Internal Medicine Physician 207R00000X MD173772 OR Primary

Addresses

Primary practice location

3521 NW Samaritan Dr Ste 201
Corvallis, OR 97330-4744

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other identifiers 4

IdentifierTypeStateIssuer
500692604MedicaidOR
597586OtherPAMEDICARE GROUP
080097556OtherPARAILROAD MEDICARE
1015043540001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sshah125591@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
I20151103002366 OR Practitioner - Internal Medicine 0042215519 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Michigan Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Good Samaritan Hospital CorvallisGroup PAC ID 1557270725, 372 clinicians

Practice addresses (Care Compare)

3521 NW Samaritan Dr
Suite 201
Corvallis, OR 97330-4744
Phone (541) 768-5140

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD173772ORMDInternal Medicine Physician
MD424815PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany General Hospital CurrentSince Apr 1, 2016 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Sep 1, 2015 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Sep 1, 2015 Accepting new patients
Albany General Hospital Current Accepting new patients
Albany General Hospital Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients

Locations

1086 7th Ave SW
Ste 101
Albany, OR 97321
Phone (541) 812-3349

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

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

3521 NW Samaritan Dr
Ste 201
Corvallis, OR 97330
Phone (541) 768-5140

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

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 69

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

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1659355899",
    "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": "3521 NW SAMARITAN DR STE 201",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304744",
            "telephone_number": "541-768-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SAMANTHA",
        "middle_name": "RAO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD424815",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD173772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500692604",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "597586",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080097556",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015043540001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshah125591@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3521 NW Samaritan Dr Ste 201",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973304744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.