Individual provider Active NPI

Samantha McBride, PSY.D.

  • Clinical Psychologist
  • Aurora, CO
National Provider Identifier
1578871851
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0004107 Issued in CO
Practice address
1890 N Revere CT
Aurora, CO 80045-7464
Phone
(720) 848-0000
NPI assigned
Sep 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PSY.0004107 CO
Clinical Psychologist 103TC0700X 0004107 CO Primary

Addresses

Primary practice location

1890 N Revere CT
Aurora, CO 80045-7464

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

13199 E Montview Blvd Ste 330
Aurora, CO 80045-7209
Phone (303) 724-3300

Other practice location 2

12605 E 16th Ave
Aurora, CO 80045-2545
Phone (720) 848-0000

Other identifiers 1

IdentifierTypeStateIssuer
12744135OtherCOCAQH

Other names 1

  • Samantha Simon Other name

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
I20141031000208 CO Practitioner - Clinical Psychologist 5294956405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0004107COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Jan 15, 2020 Accepting new patients
University Physicians Incorporated CurrentSince Jan 15, 2020 Accepting new patients
University Physicians Incorporated Psychologist PastSince Dec 27, 2020 Accepting new patients

Locations

1890 N Revere Ct
Ste 5240
Aurora, CO 80045
Phone (303) 724-3300

1890 N Revere Ct
Aurora, CO 80045
Phone (303) 724-1000

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

13199 E Montview Blvd
Ste 330
Aurora, CO 80045
Phone (303) 724-3300

Dept 1061
Denver, CO 80256

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1578871851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 N REVERE CT",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457464",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13199 E Montview Blvd Ste 330",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457209",
            "country_code": "US",
            "telephone_number": "303-724-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452545",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CO",
            "license": "PSY.0004107",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "0004107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12744135",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "SIMON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.