Samuel David Pesch, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ML61546169 Issued in WA

Practice address

940 Northgate Dr
Richland, WA 99352-3505

Phone

(509) 942-2516

NPI assigned

May 3, 2024

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

Medicare fee-for-service enrollment

Enrolled in WA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1508613969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28812 N 68TH AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853836660",
            "telephone_number": "562-714-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 NORTHGATE DR",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523505",
            "telephone_number": "509-942-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESCH",
        "first_name": "SAMUEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "ML61546169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Newhall Perry, M.D.
• Kyle Thomas Perry, DPT
• Nickole Michelle Perry, ARNP
• Personal Physical Therapy LLC
• Teena Pervaiz, MD
• Peter E Seda MD Facc PS Mid Columbia Heart and Lung Institute
• Andrew Scott Peterson, PTA
• Pamela Peterson, RN
• Peggy Ann Peterson, MA
• Susan Lynne Peterson, R.N.

• Family Medicine Physician in Richland, WA
• Providers in Richland, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.