Individual provider Active NPI

Samantha Buck, CNP

  • Family Nurse Practitioner
  • Litchfield, MN
National Provider Identifier
1043986698
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8447 Issued in MN
Practice address
612 S Sibley Ave
Litchfield, MN 55355-3340
Phone
(320) 693-4576
Fax
(320) 693-1404
NPI assigned
Aug 23, 2021
Last updated
Aug 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8447 MN Primary

Addresses

Primary practice location

612 S Sibley Ave
Litchfield, MN 55355-3340

Mailing address

612 S Sibley Ave
Litchfield, MN 55355-3340
Phone (320) 693-4576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922000891 MN Practitioner - Nurse Practitioner 7416354261 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of MeekerGroup PAC ID 0840109740, shared by 4 NPIs, 44 clinicians

Practice addresses (Care Compare)

612 S Sibley Ave
Litchfield, MN 55355-3340
Phone (320) 693-3233

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.1 of 100Reported as group
Quality
91.46
Promoting interoperability
86
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8447MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Meeker CurrentSince Sep 6, 2021 Accepting new patients
County of Meeker CurrentSince Sep 6, 2021 Accepting new patients
County of Meeker Past Accepting new patients
County of Meeker Past Accepting new patients

Locations

740 Parker Ave W
Dassel, MN 55325
Phone (320) 275-4330

611 S Sibley Ave
Litchfield, MN 55355
Phone (320) 693-2804

612 S Sibley Ave
Litchfield, MN 55355
Phone (320) 693-3242

Interoperability endpoints

  • Direct secure messaging: sbuck585138@direct.centracare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1043986698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S SIBLEY AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553553340",
            "telephone_number": "320-693-4576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S SIBLEY AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553553340",
            "telephone_number": "320-693-4576",
            "fax_number": "320-693-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "SAMANTHA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield, MN

Sources for this page

Verify at the official NPI Registry.