JACQUELINE SAMMONS (NP-C) – Psychiatric/Mental Health Nurse Practitioner, NPI 1235539594
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JACQUELINE SAMMONS (NP-C)
14757 SW OREGON TRAIL LN
BEAVERTON, OR 970065908
Phone: (303) 868-3249
Type: Mailing
1500 NW BETHANY BLVD
BEAVERTON, OR 970065208
Phone: (303) 868-3249
Type: Location
2237 NW EDGEWOOD PL
PORTLAND, OR 972297618
Phone: (303) 868-3249
Type: Mailing
17704 JEAN WAY
LAKE OSWEGO, OR 970355497
Phone: (503) 675-6776
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: 2023-09-15
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 |
|---|---|---|---|---|
| I20210514000384 | I | Nurse Practitioner | WA | TBD |
| I20230915000876 | I | Nurse Practitioner | MT | 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 |
|---|---|---|---|---|
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 31 | 31 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 17 | 17 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 97006)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OR | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | OR | |
| Physician Assistant | NV | |
| - | OR | |
| - | OR | |
| Nurse Practitioner | OR | |
| Physician Assistant | WA | |
| - | OR | |
| - | FL |
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