MARYAM SAUDAGARAN (AGPCNP) – Gerontology Nurse Practitioner, NPI 1083248504
Gerontology Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
3,379 NURSE PRACTITIONER in OR
Provider Addresses for MARYAM SAUDAGARAN (AGPCNP)
10140 SW Parkway
Portland, OR 972255008
Phone: (503) 215-2669
Type: Location
1717 S J ST
TACOMA, WA 984054933
Phone:
Type: Mailing
1717 SOUTH J STREET
10TH FLOOR/MS 01-61
TACOMA, WA 98405
Phone: (253) 426-4101
Type: Location
PO BOX 3158
PORTLAND, OR 972083158
Phone: (503) 215-6494
Type: Mailing
6350 NE HALSEY ST
PORTLAND, OR 972134720
Phone: (503) 215-2669
Type: Location
1850 NW MYHRE RD
SILVERDALE, WA 983837663
Phone: (564) 240-3085
Fax: (564) 240-3126
Type: Mailing
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: 2023-08-25
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230825001975 | I | Nurse Practitioner | OR | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0318 | Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualif | 119 | 12 | $0 |
| G0316 | Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by th | 118 | 16 | $0 |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 20 | 13 | $0 |
| 99497 | Advance care planning, first 30 minutes | 20 | 15 | $0 |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 17 | 17 | $0 |
Insurance plans in this area (ZIP 97225)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | OR | |
| Physician Assistant | OR | |
| - | OR | |
| N E U R O L O G Y | OR | |
| Nurse Practitioner | OR | |
| Infectious Disease, Internal Medicine | OR | |
| Thoracic Surgery | OR | |
| Nurse Practitioner | OR | |
| Physician Assistant | WA | |
| Clinical Psychologist | OR |
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