Samantha Dee Jensen, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A176763 Issued in IA

Practice address

1378 NW 124TH St # 200
Clive, IA 50325-8151

Phone

(515) 288-6097

NPI assigned

Nov 2, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Dee Kucharo Former name

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CNR Development LLCGroup PAC ID 3870838030, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unitypoint Health - Marshalltown Hospital, Marshalltown, IA, CCN 160001
• Pella Regional Health Center Hospital, Pella, IA, CCN 161367

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjensen3948084@direct.trinity-health.org

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.

• CNR Development, LLC

  • Dermatology Physician
  • Pella, IA
  • NPI 1699241240

  IA

  Medicare reassignment Care Compare group NPD
• Iowa Digestive Disease Center P.C.

  • Gastroenterology Physician
  • Clive, IA
  • NPI 1275571747

  IA

  Medicare reassignment NPD

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

• Pella Regional Health Center

  • Critical Access Hospital
  • Pella, IA
  • NPI 1578520888

  Hospital

  Care Compare affiliation
• Unitypoint Health - Marshalltown

  • General Acute Care Hospital
  • Marshalltown, IA
  • NPI 1629503057

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1083487920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 CORNERSTONE LN",
            "city": "PLEASANT HILL",
            "state": "IA",
            "postal_code": "503278916",
            "telephone_number": "515-344-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1378 NW 124TH ST # 200",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258151",
            "telephone_number": "515-288-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "SAMANTHA",
        "middle_name": "DEE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A176763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "KUCHARO",
            "middle_name": "DEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carrie Janeczko, AUD
• Mary Louise Jankowski, LMHC, LMSW
• Erin M Jenkins, ARNP
• Jennifer Denhartog OD LLC
• Brandi Jensen
• Korbyn R. Jerabek, PA-C
• Jacob Jipp, M.D.
• JMG Therapy and Counseling
• Jillian Anne Johns
• Amanda Lee Johnson, LMSW

• All providers in Clive, IA
• Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.