Samer Abufadil, MD
Individual provider Active NPI Internal Medicine Physician · Clackamas, OR
NPI 1750437653 · NPPES record last updated Feb 4, 2022
Key facts
- NPI
- 1750437653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD27191 (OR)
- Practice address
- 10180 SE Sunnyside Rd
Clackamas, OR 97015-8970 - Phone
- (503) 652-2880
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of Oklahoma College of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kaiser Foundation Health Plan of the Northwest
Practice addresses (Care Compare)
10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000
Hospital & facility affiliations
- Kaiser Sunnyside Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OR, WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070928000164 | OR | Practitioner - Internal Medicine | 5597655209 | Reassigns benefits to 1 organization |
| I20220528000274 | WA | Practitioner - Internal Medicine | 5597655209 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048102 | GA | MD | Internal Medicine Physician |
| MD11798 | HI | MD | Internal Medicine Physician |
| 2001032139 | MO | MD | Internal Medicine Physician |
| MD27191 | OR | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Internal Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Internal Medicine | Current |
Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Internal Medicine | Current |
Accepting new patients |
| Kaiser Foundation Hospitals | Past | Accepting new patients |
Locations
10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
13705 NE Airport Way
Portland, OR 97230
Phone (503) 258-6800
7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 5194 | AK | |
| Internal Medicine Physician | 207R00000X | 2001032139 | MO | |
| Internal Medicine Physician | 207R00000X | MD11798 | HI | |
| Internal Medicine Physician | 207R00000X | 048102 | GA | |
| Internal Medicine Physician | 207R00000X | MD27191 | OR | Yes |
Addresses
Primary practice location
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Mailing address
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Northwest Permanente PC |
Other providers in Clackamas, OR
- Paul Jeffrey Aanderud
- Aaron Christopher Abajian
- Isaac Thomas Abernethy
- Able Palms Home Health of Oregon, LLC
- Matthew Spencer Abrahams
- Accident Care Chiropractic and Massage of Clackamas Inc
- Douglas Armstrong Ackerman
- Active Recovery TMS PLLC
- Allyson Adams
- Celisse Adams
All providers in Clackamas, OR · Internal Medicine Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.