Samantha Bendzick

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12626 Issued in MN

Practice address

111 Hundertmark Rd
Chaska, MN 55318-4551

Phone

(952) 448-2050

NPI assigned

May 9, 2016

Last updated

Mar 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

University of Florida College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056
• St Francis Regional Medical Center Hospital, Shakopee, MN, CCN 240104

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbendzick190997@excellian.direct.allina.com

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.

• Allina Health System

  dba Allina Health Annandale Clinic

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment Care Compare group
• Ridgeview Medical Center

  dba Ridgeview Medical Center CRNAs

  • Certified Registered Nurse Anesthetist
  • Waconia, MN
  • NPI 1528364429
  Medicare reassignment Care Compare group
• Minnesota Valley Health Center Inc

  • Critical Access Hospital
  • Le Sueur, MN
  • NPI 1730248907
  Medicare reassignment NPD
• Sibley Medical Center

  dba Ridgeview Sibley Medical Center

  • Critical Access Hospital
  • Arlington, MN
  • NPI 1740240225
  Medicare reassignment NPD
• Allina Health System

  dba Allina Health Cancer Institute - Lakeville

  • Oncology Clinic/Center
  • Lakeville, MN
  • NPI 1427884972
  NPD
• Allina Health System

  dba Allina Health Forest Lake Clinic

  • Family Medicine Physician
  • Forest Lake, MN
  • NPI 1447556261
  NPD
• Allina Health System

  dba Allina Health TeleRheumatology

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• Minnesota Valley Health Center Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Le Sueur, MN
  • NPI 1215097902
  NPD
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Chaska, MN
  • NPI 1710748538
  NPD
• Ridgeview Medical Center

  • Diagnostic Radiology Physician
  • Waconia, MN
  • NPI 1811174923
  NPD

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

• Ridgeview Medical Center

  • General Acute Care Hospital
  • Waconia, MN
  • NPI 1275608457
  Care Compare affiliation
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Chaska, MN
  • NPI 1710748538
  Care Compare affiliation
• St Francis Regional Medical Center

  • General Acute Care Hospital
  • Shakopee, MN
  • NPI 1578520045
  Care Compare affiliation

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1154777225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HUNDERTMARK RD",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553184551",
            "telephone_number": "952-448-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDZICK",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109609",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbendzick190997@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "111 Hundertmark Rd",
            "city": "Chaska",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553184551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Chaska, MN
• Providers in Chaska, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.