Samantha Bartelt, PMHNP-BC

Key facts

NPI

1013744937

Entity type

Individual (NPI type 1)

Primary specialty

Psychiatric/Mental Health Nurse Practitioner 363LP0808X

License

12192 (MN)

Practice address

4000 28TH Ave S
Moorhead, MN 56560-7926

Phone

(701) 234-3200

NPI assigned

Sep 16, 2024

Sex

Female

Sole proprietor

No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sanford Medical Center Fargo Family Medicine Physician · West Fargo, ND · NPI 1184917924
  Medicare reassignment NPD MN · ND
• Sanford Medical Center Fargo Rural Health Clinic/Center · Pelican Rapids, MN · NPI 1114953627
  NPD
• Sanford Medical Center Fargo Rural Health Clinic/Center · Forman, ND · NPI 1073520003
  NPD
• Sanford Medical Center Fargo General Acute Care Hospital · Fargo, ND · NPI 1528009412
  NPD

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sanford Health of Northern Minnesota Ambulatory Surgical Clinic/Center · Bemidji, MN · NPI 1093876922
  Care Compare affiliation Hospital
• Sanford Medical Center Fargo Family Medicine Physician · West Fargo, ND · NPI 1184917924
  Care Compare affiliation Hospital
• Sanford Medical Center Fargo General Acute Care Hospital · Fargo, ND · NPI 1245519081
  Care Compare affiliation Hospital
• Sanford Medical Center Fargo General Acute Care Hospital · Fargo, ND · NPI 1528009412
  Care Compare affiliation Hospital
• Sanford Medical Center Fargo Air Ambulance · Fargo, ND · NPI 1942415468
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sanford Medical Center Fargo (1,210 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Medical Center Fargo Hospital · Fargo, ND · CCN 350011

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in MN, ND

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 13, 2024.

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1013744937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 28TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565607926",
            "telephone_number": "701-234-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTELT",
        "first_name": "SAMANTHA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R35215",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "198792-8",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ND",
            "license": "201280",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "12192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

• Slyvine M Bamba
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• Courtney Marie Banister
• Erin Barr
• Casey Clay Bartz, O.D.
• Rachel Noel Bartz
• Sadie Baxter
• Carley Marie Bayer, APRN, CNP
• Rebecca Bayliss, RN

All providers in Moorhead, MN · Psychiatric/Mental Health Nurse Practitioner in Minnesota