Sampson Ndikum
Individual provider Active NPI Family Nurse Practitioner · Fort Collins, CO
NPI 1073294757 · NPPES record last updated Jul 26, 2023
Key facts
- NPI
- 1073294757
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0998960 (CO)
- Practice address
- 802 W Drake Rd Ste 145
Fort Collins, CO 80526-5567 - Phone
- (970) 449-5122
- NPI assigned
- Jul 26, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 19
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northern Colorado Hospitalists Professional LLC
Practice addresses (Care Compare)
1024 S Lemay Ave
Poudre Valley Hospital
Fort Collins, CO 80524-3929
Phone (970) 495-7142
2021 Battlecreek Dr
Unit a
Fort Collins, CO 80528-5120
Phone (970) 231-4008
Hospital & facility affiliations
- Canyon Home Care
- Columbine Poudre Home Care
- Poudre Valley Hospital
- Medical Center of the Rockies
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.23 of 100
- Quality
- 87
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231018000637 | CO | Practitioner - Nurse Practitioner | 0345695854 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0998960 | CO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Colorado Hospitalists Professional LLC | Multi-Specialty | Current |
Accepting new patients |
Locations
802 W Drake Rd
Ste 101
Fort Collins, CO 80526
Phone (970) 221-2273
802 W Drake Rd
Ste 145
Fort Collins, CO 80526
Phone (970) 449-5122
1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000
802 W Drake Rd
Fort Collins, CO 80526
Phone (970) 482-0198
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | 0998960 | CO | Yes |
Addresses
Primary practice location
802 W Drake Rd Ste 145
Fort Collins, CO 80526-5567
Mailing address
802 W Drake Rd Ste 145
Fort Collins, CO 80526-5567
Phone (970) 449-5122
Other providers in Fort Collins, CO
- Ncap Imh, LLC
- Ncdi Adults Professional LLP
- Ncdi Drake, Professional LLP
- Ncdi Oak, Profession LLP
- NCMC Specialty Clinic
- Mark Neagle
- Ann Renee Neal
- Susannah G Neal
- Jennifer Marie Nealis
- Lauren Nebbergall
All providers in Fort Collins, CO · Family Nurse Practitioner in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.