Ali Adela Sambursky, DNP, AGACNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

17328-33 Issued in WI

Practice address

6400 Fannin St Ste 2800
Houston, TX 77030-1534

Phone

(713) 486-8000

Fax

(713) 795-8115

NPI assigned

Jan 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other names 1

• Ms. Ali Adela Payan Former name

Medicare fee-for-service enrollment

Enrolled in FL, TX, NC, MO, NY, WI, LA7 enrollments

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 7

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Wyoming CountyGroup PAC ID 9335118967, 40 clinicians

Hannibal Regional Healthcare System IncGroup PAC ID 1254236300, 256 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
• FHIR API: https://epicproxy.et0747.epichosted.com/APIProxyPRD/api/FHIR/R4/

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.

• Hannibal Regional Healthcare System Inc

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1003956095
  Medicare reassignment Care Compare group NPD
• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731

  FL

  Medicare reassignment Care Compare group NPD
• Wyoming County

  • Emergency Medicine Physician
  • Warsaw, NY
  • NPI 1407060759
  Medicare reassignment Care Compare group NPD
• Freeman-Oak Hill Health System

  dba Freeman Physician Group

  • Multi-Specialty Clinic/Center
  • Joplin, MO
  • NPI 1679517023

  Neurology

  Medicare reassignment NPD
• Freeman-Oak Hill Health System

  dba Freeman Health System

  • General Acute Care Hospital
  • Joplin, MO
  • NPI 1891809679
  Medicare reassignment NPD
• North Oaks Medical Center, LLC

  dba North Oaks Med Ctr Professional Billing

  • General Acute Care Hospital
  • Hammond, LA
  • NPI 1972630705

  TX

  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• SSM Regional Health Services

  dba SSM Health Medical Group- Cardiothoracic Surgery

  • Clinic/Center
  • Jefferson City, MO
  • NPI 1649217837
  Medicare reassignment NPD
• University of Miami

  dba UMiami Medicine - Hepatology

  • Hepatology Physician
  • Miami, FL
  • NPI 1013967827
  Medicare reassignment NPD
• Agnesian Healthcare, Inc

  dba SSM Health St Agnes Hospital Fond Du Lac

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1346228541
  Medicare reassignment
• The Monroe Clinic, Inc.

  dba SSM Health Monroe Clinic Medical Group

  • Specialist
  • Monroe, WI
  • NPI 1386720548
  Medicare reassignment
• Agnesian Healthcare Inc

  dba SSM Health Pharmacy

  • Community/Retail Pharmacy
  • Waupun, WI
  • NPI 1366417917
  NPD

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1508455635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST STE 2070",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301541",
            "telephone_number": "713-486-7746",
            "fax_number": "713-500-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST STE 2800",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301534",
            "telephone_number": "713-486-8000",
            "fax_number": "713-795-8115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467694",
            "country_code": "US",
            "telephone_number": "678-312-1000",
            "fax_number": "678-312-3282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15790 Paul Vega Dr",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "LA",
            "postal_code": "704031436",
            "country_code": "US",
            "telephone_number": "985-230-1683",
            "fax_number": "985-230-6652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6000 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "634016887",
            "country_code": "US",
            "telephone_number": "573-248-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Hawthorne Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042515",
            "country_code": "US",
            "telephone_number": "704-384-9437",
            "fax_number": "704-384-9440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1102 W 32nd St",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043503",
            "country_code": "US",
            "telephone_number": "417-347-4570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMBURSKY",
        "first_name": "ALI",
        "middle_name": "ADELA",
        "name_prefix": "Mrs.",
        "credential": "DNP, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "17328-33",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1112785",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "234371",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5019397",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11009996",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "GAA-NP001959",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2024007851",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALI",
            "last_name": "PAYAN",
            "middle_name": "ADELA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Cynthia Sambataro, DOCTOR OF HEALTH PSY
• Famara Ben Magueye Sambe
• Samcooke Medical Supplies, Inc.
• Samcos Healthcare Services, Inc
• Sheema Samdani, D.O
• Saida Samedova, OD
• Fnu Sameeta, M.D.

• Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.
• 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.