SAMUEL L COLLINS (PA-C) – Physician Assistant, NPI 1225107089
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,876 PHYSICIAN ASSISTANT in OR
Provider Addresses for SAMUEL L COLLINS (PA-C)
3355 Riverbend Dr
Suite 300
Springfield, OR 974778800
Phone: (541) 868-9323
Fax: (541) 868-9306
Type: Location
1400 E Kincaid St
Mount Vernon, WA 982744127
Phone: (360) 428-2586
Fax: (360) 428-6470
Type: Location
1510 E BROADWAY
MOUNT VERNON, WA 982744523
Phone: (541) 231-2591
Type: Mailing
203 S WESTERN AVE
TONASKET, WA 988558803
Phone: (509) 486-3144
Type: Location
1400, East Kincaid Street, Mount Vernon, Skagit County, Washington, 98274, United States
ATTN: CREDENTIALING
MOUNT VERNON, WA 982744127
Phone: (360) 428-2500
Fax: (360) 428-6485
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: 2023-01-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20140818002759 | I | Physician Assistant | WA | TBD |
| I20230106002072 | I | Physician Assistant | CA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97477)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | WA | |
| Family Practice | WA | |
| Diagnostic Radiology | WA | |
| Emergency Medicine, Family Practice | MT | |
| Emergency Medicine | WA | |
| General Practice, Diagnostic Radiology, Interventional Radiology | WA | |
| Diagnostic Radiology | WA | |
| Diagnostic Radiology | WA | |
| Diagnostic Radiology, Nuclear Medicine | WA |
Reviews
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