Samantha Considine Pezon, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

81795 Issued in MN

Practice address

11095 Viking Dr Ste 250
Eden Prairie, MN 55344-7229

Phone

(952) 278-7000

NPI assigned

Mar 23, 2023

Last updated

Sep 25, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/1846cf9e-8006-4277-b72f-3cbbe8a8f5ca/

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.

• Southdale Pediatric Associates, LTD

  • Multi-Specialty Clinic/Center
  • Edina, MN
  • NPI 1245305895
  NPD (past)

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1114620721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 300",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351803",
            "telephone_number": "952-278-7000",
            "fax_number": "952-831-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11095 VIKING DR STE 250",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447229",
            "telephone_number": "952-278-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 E Nicollet Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553376785",
            "country_code": "US",
            "telephone_number": "952-278-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6600 France Ave S Ste 315",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554351803",
            "country_code": "US",
            "telephone_number": "952-278-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEZON",
        "first_name": "SAMANTHA",
        "middle_name": "CONSIDINE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "81795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Peterson
• Nathaniel L Peterson, DPT
• Wyatt Peterson, O.D.
• Cindy J Petrie, RN, WOC
• Deborah K Petron, OTRL
• Kelsey Mariah Pfaltzgraff
• Tuong Vy Pham, RPH
• Vivian Thanh Pham
• Ashley Brooke Phillips, FNP-C
• Maggie Elizabeth Phillips, FNP-BC

• Pediatrics Physician in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; 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.