Thomas David Sanderson, AGACNP - Medicare Nurse Practitioner in Portland, OR

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Thomas David Sanderson, AGACNP is a medicare enrolled "Nurse Practitioner - Gerontology" in Portland, Oregon. His current practice location is 4400 Ne Halsey St Ste 102, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 962-1000.

Thomas David Sanderson is licensed to practice in Oregon (license number 201904283NP-PP) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1275171316.

Contact Information

Thomas David Sanderson, AGACNP
4400 Ne Halsey St Ste 102,
Portland, OR 97213-1545
(503) 962-1000
Not Available

Map and Direction




Provider's Profile

Full NameThomas David Sanderson
GenderMale
SpecialityNurse Practitioner - Gerontology
Location4400 Ne Halsey St Ste 102, Portland, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1275171316
  • Provider Enumeration Date: 12/19/2019
  • Last Update Date: 04/25/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 3971912726
  • Enrollment ID: I20210506001364

Medical Identifiers

Medical identifiers for Thomas David Sanderson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275171316NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WE0003XRegistered Nurse - Emergency 201904282RN (Oregon)Secondary
363L00000XNurse Practitioner 201904283NP-PP (Oregon)Secondary
363LG0600XNurse Practitioner - Gerontology 201904283NP-PP (Oregon)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Thomas David Sanderson allows following entities to bill medicare on his behalf.
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023488343
PECOS PAC ID: 0648183608
Enrollment ID: O20031106000652
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003991845
PECOS PAC ID: 5395656284
Enrollment ID: O20031113000626
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114015971
PECOS PAC ID: 9335057447
Enrollment ID: O20031117000153
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093976243
PECOS PAC ID: 3476450560
Enrollment ID: O20031217000186

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Thomas David Sanderson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Thomas David Sanderson, AGACNP
Po Box 3158,
Portland, OR 97208-3158

Ph: (503) 215-6494		Thomas David Sanderson, AGACNP
4400 Ne Halsey St Ste 102,
Portland, OR 97213-1545

Ph: (503) 962-1000

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.