SAMANTHA JAY ABBOTT (FNP) – Family Nurse Practitioner, NPI 1043855257

SAMANTHA JAY ABBOTT (FNP) is a healthcare provider. based in Canby, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 201909196NP-PP (OR). The NPI Number for SAMANTHA JAY ABBOTT (FNP) is 1043855257

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
SAMANTHA JAY ABBOTT (FNP)
NPI
1043855257
Phone
(503) 416-4547
Address
178 SW 2nd Ave
Enumeration Date
12 November 2019
Last Update Date
30 March 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5034161960
Graduation Year
2019 (7 years ago)
PAC ID
3274963053
Group Practice PAC ID
8426227893
Professional Enrollment ID
I20200417002664
Address ID
OR972226656MI10330AVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

3,379 NURSE PRACTITIONER in OR

Provider Addresses for SAMANTHA JAY ABBOTT (FNP)

  • 178 SW 2nd Ave

    Canby, OR 970134152

    Phone: (503) 416-4547

    Fax: (503) 416-4553

    Type: Location

  • 7320 SW HUNZIKER RD STE 300

    PORTLAND, OR 972232302

    Phone: (503) 941-3077

    Type: Mailing

  • 10330 SE 32ND AVE STE 325

    MILWAUKIE, OR 972226656

    Phone: (503) 416-1960

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-04-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200417002664INurse PractitionerORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97013)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426227893View full group profile
NameSpecialtyState
Nurse PractitionerOR
-OR
Physician AssistantMO
Physician AssistantOR
Family PracticeOR
Physician AssistantNV
Clinical Social WorkerWA
Family PracticeOR
Internal MedicineOR
Family PracticeOR

Reviews

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Frequently asked questions

Does SAMANTHA JAY ABBOTT (FNP) have a public NPI I can cite?
Public records show SAMANTHA JAY ABBOTT (FNP) under NPI 1043855257.
Should I treat SAMANTHA JAY ABBOTT (FNP) as an active provider?
Patients and plans typically see SAMANTHA JAY ABBOTT (FNP) as active in the national extract.
What services align with SAMANTHA JAY ABBOTT (FNP)'s listing?
SAMANTHA JAY ABBOTT (FNP)'s public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is SAMANTHA JAY ABBOTT (FNP) tied to Canby, Oregon?
If you are local to Canby, Oregon, SAMANTHA JAY ABBOTT (FNP) may be relevant to your search.
Can I export SAMANTHA JAY ABBOTT (FNP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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