Samantha Elizabeth Polikowski, R.N.

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

95001608 Issued in CA

Practice address

55 Fruit St
Boston, MA 02114-2621

Phone

(617) 724-4910

NPI assigned

Aug 4, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA, CA2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Escondido Anesthesia Associates LPGroup PAC ID 5799034518, 5 clinicians

Samantha Polikowski Anesthesia IncGroup PAC ID 1951742543, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Registered Nurse

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.

• Samantha Polikowski Anesthesia Inc

  • Certified Registered Nurse Anesthetist
  • Chula Vista, CA
  • NPI 1851157028

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD Authorized official
• Escondido Anesthesia Associates LP

  • Certified Registered Nurse Anesthetist
  • Escondido, CA
  • NPI 1588151120

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Pratt Anesthesiology Associates, Inc

  • Anesthesiology Physician
  • Boston, MA
  • NPI 1326085390
  Medicare reassignment NPD
• Concierge Anesthesia

  • Anesthesiology Physician
  • Thousand Oaks, CA
  • NPI 1447726997
  Medicare reassignment NPD
• Equanimity Anesthesia Professional Corporation

  • Anesthesiology Physician
  • San Diego, CA
  • NPI 1942024393
  Medicare reassignment NPD
• Innovative Anesthesia Consultants PC

  • Anesthesiology Physician
  • La Mesa, CA
  • NPI 1154815264
  Medicare reassignment NPD
• La Jolla Anesthesia Associates LP

  • Certified Registered Nurse Anesthetist
  • La Jolla, CA
  • NPI 1649717737

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Regents of the University of California

  • Certified Registered Nurse Anesthetist
  • San Diego, CA
  • NPI 1265535702

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Southern California Gastroenterology Anesthesia Specia

  • Certified Registered Nurse Anesthetist
  • San Diego, CA
  • NPI 1073997359

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1558463927
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1023425972
  NPD

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1194134114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-4910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "995 Gateway Center Way Ste 207",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921024544",
            "country_code": "US",
            "telephone_number": "619-263-9729",
            "fax_number": "619-263-9730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLIKOWSKI",
        "first_name": "SAMANTHA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MA",
            "license": "2267172",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95001608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sergio Poli de Frias, MD
• Gabrielle Poliak
• Christina Eileen Policano
• Heather Polidi, LICSW
• Kelsey Polikowski
• Alisha Polini, CPNP-PC
• A. Stephen Polins, DDS
• Cathleen Marie Poliquin, N.P.
• Olivia Polise
• Teja Polisetty

• Certified Registered Nurse Anesthetist in Boston, MA
• Providers in Boston, MA by specialty
• Certified Registered Nurse Anesthetist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.