Samuel Jesse Anthony II, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

76012 Issued in MN

Practice address

2401 Fairview Ave N Ste 145
Roseville, MN 55113-2710

Phone

(888) 290-1209

Fax

(833) 973-3529

NPI assigned

May 7, 2019

Last updated

Jul 23, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL, MN2 enrollments

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 2

Specialty

Family Practice

Education

Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

First Care Medical ServicesGroup PAC ID 3678542842, shared by 6 NPIs, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health Fosston Hospital, Fosston, MN, CCN 241357

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• First Care Medical Services

  dba Essentia Health Fosston Clinic

  • Critical Access Hospital Clinic/Center
  • Fosston, MN
  • NPI 1073638565

  Single Specialty

  Medicare reassignment NPD
• First Care Medical Services

  dba Essentia Health Fosston

  • Critical Access Hospital
  • Fosston, MN
  • NPI 1497850119
  Medicare reassignment NPD
• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631

  Single Specialty

  Medicare reassignment NPD
• Ecm Health Group LLC

  • Obstetrics & Gynecology Physician
  • Florence, AL
  • NPI 1346588852

  Single Specialty

  Medicare reassignment NPD
• Grand Itasca Clinic and Hospital

  dba Grand Itasca Pharmacy

  • Community/Retail Pharmacy
  • Grand Rapids, MN
  • NPI 1225441157
  NPD

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

• First Care Medical Services

  dba Essentia Health Fosston

  • Critical Access Hospital
  • Fosston, MN
  • NPI 1497850119
  Care Compare affiliation

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1154986024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20515 ASPEN DR",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557444792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 FAIRVIEW AVE N STE 145",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132710",
            "telephone_number": "888-290-1209",
            "fax_number": "833-973-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "SAMUEL",
        "middle_name": "JESSE",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-07",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "76012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samuel.anthony.1@31254.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "Herself Health MN PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2004 Ford Pkwy",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551161931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julie Anne Andersson, PA
• Maria Jose Andrade Kemper
• Karl Haakon Andreasen, D.D.S.
• Andrya Dieter, PSYD, LP, LLC
• Camille Angeles-Castle, FNP-C
• Amy Antilla
• Apex Optometry Resources LLC (Graf Optical)
• Approach Enterprises L.L.C
• Ibrahim Arale
• Joan Rosalie Arbour, D.C.

• Family Medicine Physician in Roseville, MN
• Providers in Roseville, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.