Samuel Tyler Medick, DNP, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61353336 Issued in WA

Practice address

8212 S March Point Rd
Anacortes, WA 98221-8684

Phone

(360) 588-2800

NPI assigned

Sep 28, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Tulalip Tribes of Washington Quil Ceda Creek Counseling

  dba Quil Ceda Creek Counseling Company

  • General Practice Physician
  • Tulalip, WA
  • NPI 1578272712
  Medicare reassignment NPD
• Stillaguamish Tribe of Indians

  dba Iccs

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Arlington, WA
  • NPI 1790826600
  NPD
• Swinomish Health Services

  dba Swinomish Wellness Program

  • Substance Abuse Rehabilitation Facility
  • Anacortes, WA
  • NPI 1710182787
  NPD
• Tulalip Tribes of Washington Quil Ceda Creek Counseling

  dba Quil Ceda Creek Counseling Company

  • Methadone Clinic
  • Tulalip, WA
  • NPI 1699356683
  NPD

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1083338537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8212 S MARCH POINT RD",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982218684",
            "telephone_number": "360-588-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8212 S MARCH POINT RD",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982218684",
            "telephone_number": "360-588-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDICK",
        "first_name": "SAMUEL",
        "middle_name": "TYLER",
        "credential": "DNP, ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61353336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Hodgins McKellar, RDH
• Kelly Suzanne McKittrick, CNM, ARNP
• Nora B McMillan, ARNP
• Malcolm Douglas McPhee, DPT
• Susan Hill Meagher, R.N.
• Virginia Ann Meindl, M.S.
• Lisa Michelle Melody, PA-C
• Dion Lynn Menser-Andreini, LMFT
• Coralie Sophie Meslin, ARNP
• Mallory Ruth Metzger, M.S., CCC-SLP

• Family Nurse Practitioner in Anacortes, WA
• Providers in Anacortes, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.