Individual provider Active NPI

William Oliver Samuelson IV, MD

  • Orthopaedic Surgery Physician
  • Dakota Dunes, SD
National Provider Identifier
1518374644
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
12307 Issued in SD
Practice address
575 N Sioux Point Road
Dakota Dunes, SD 57049-5312
Phone
(605) 217-2667
Fax
(605) 217-2900
NPI assigned
Jul 21, 2014
Last updated
Dec 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Orthopaedic Surgery Physician 207X00000X 60328 MN
Orthopaedic Surgery Physician 207X00000X 32965 NE
Orthopaedic Surgery Physician 207X00000X MD-47819 IA
Orthopaedic Surgery Physician 207X00000X 12307 SD Primary

Addresses

Primary practice location

575 N Sioux Point Road
Dakota Dunes, SD 57049-5312

Mailing address

575 N Sioux Point Road
Dakota Dunes, SD 57049-5312
Phone (605) 217-2667

Other practice location 1

2730 Pierce St Ste 300
Sioux City, IA 51104-3765
Phone (712) 224-8677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE, SD3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20200810001774 IA Practitioner - Orthopedic Surgery 0547488298 Reassigns benefits to 1 organization
I20201027000375 NE Practitioner - Orthopedic Surgery 0547488298 Reassigns benefits to 1 organization
I20210513002500 SD Practitioner - Orthopedic Surgery 0547488298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Texas Tech University Health Science Center School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cnos PCGroup PAC ID 4284548942, 98 clinicians

Practice addresses (Care Compare)

2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone (712) 279-3500

2735 Outer Dr N
Cnos Northside
Sioux City, IA 51104-1590
Phone (712) 224-5692

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone (605) 217-2667

600 N Sioux Point Rd
Dakota Dunes, SD 57049-5000
Phone (605) 232-3332

801 5TH St
Sioux City, IA 51101-1326
Phone (712) 279-2010

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion262
Laminectomy or laminotomy (partial removal of spine bones)72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-47819IAMDOrthopaedic Surgery Physician
60328MNMDOrthopaedic Surgery Physician
32965NEMDOrthopaedic Surgery Physician
12307SDMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Cnos, PC Orthopaedic Surgery CurrentSince Jan 3, 2022 Accepting new patients
Cnos PC Orthopaedic Surgery CurrentSince Jan 3, 2022 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

100 Medical Pkwy
Denison, IA 51442
Phone (712) 265-2500

714 Lincoln St NE
Le Mars, IA 51031
Phone (712) 546-3338

1000 Lincoln Cir SE
Orange City, IA 51041
Phone (712) 737-2000

2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000

2730 Pierce St
Ste 300
Sioux City, IA 51104
Phone (712) 234-1005

2735 Outer Dr N
Sioux City, IA 51104
Phone (712) 224-5692

5708 Sunnybrook Ct
Sioux City, IA 51106

201 E 4th St
Ste 202
South Sioux City, NE 68776

1200 Providence Rd
Wayne, NE 68787
Phone (402) 375-3800

575 N Sioux Point Rd
North Sioux City, SD 57049
Phone (605) 217-2615

600 N Sioux Point Rd
North Sioux City, SD 57049
Phone (605) 217-4320

Interoperability endpoints

  • Direct secure messaging: williamsamuelson@cnos.allscriptsdirect.net
  • Direct secure messaging: wsamuelson783242@direct.unitypoint.org

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1518374644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N SIOUX POINT ROAD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495312",
            "telephone_number": "605-217-2667",
            "fax_number": "605-217-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N SIOUX POINT ROAD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495312",
            "telephone_number": "605-217-2667",
            "fax_number": "605-217-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2730 Pierce St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Sioux City",
            "state": "IA",
            "postal_code": "511043765",
            "country_code": "US",
            "telephone_number": "712-224-8677",
            "fax_number": "712-277-1662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "WILLIAM",
        "middle_name": "OLIVER",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-21",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "60328",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NE",
            "license": "32965",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IA",
            "license": "MD-47819",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SD",
            "license": "12307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dakota Dunes, SD

Sources for this page

Verify at the official NPI Registry.