Individual provider Active NPI

Asani H Seawell

  • Clinical Psychologist
  • Portland, OR
National Provider Identifier
1942715339
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2807 Issued in OR
Practice address
1040 NW 22ND Ave Ste 520
Portland, OR 97210-3097
Phone
(503) 413-7557
NPI assigned
Dec 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2807 OR Primary

Addresses

Primary practice location

1040 NW 22ND Ave Ste 520
Portland, OR 97210-3097

Mailing address

190 SE 8TH Ave Ste 260
Hillsboro, OR 97123-4216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180130000893 OR Practitioner - Clinical Psychologist 8921368515 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1040 NW 22ND Ave
Portland, OR 97210-3097

1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone (503) 413-7074

Merit-based Incentive Payment System (MIPS)

Final score
92.34 of 100Reported as group
Quality
92.55
Promoting interoperability
100
Improvement activities
40
Cost
76.53

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Jan 29, 2018 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Jan 29, 2018 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients

Locations

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

1040 NW 22nd Ave
Ste 520
Portland, OR 97210
Phone (503) 413-7557

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1942715339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 SE 8TH AVE STE 260",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE STE 520",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103097",
            "telephone_number": "503-413-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEAWELL",
        "first_name": "ASANI",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.