Individual provider Active NPI

Samantha Pelican Monson, PSYD

  • Psychologist
  • Denver, CO
National Provider Identifier
1215247002
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3502 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204-4507
Phone
(720) 956-2586
NPI assigned
Oct 14, 2010
Last updated
Mar 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3502 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4507

Mailing address

1001 Yosemite St
Denver, CO 80230-6074
Phone (720) 956-2586

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smonson10110@direct.dhha.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110401000029 CO Practitioner - Clinical Psychologist 0446433213 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3502COMDPsychologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1215247002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 YOSEMITE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802306074",
            "telephone_number": "720-956-2586",
            "fax_number": "720-956-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "720-956-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONSON",
        "first_name": "SAMANTHA",
        "middle_name": "PELICAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smonson10110@direct.dhha.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Bannock St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802044507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.