Samantha Rae Sellke

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.023777 Issued in OH

Practice address

155 Crocker Park Blvd
Westlake, OH 44145-6987

Phone

(440) 575-5762

NPI assigned

Oct 15, 2018

Sex

Female

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 OH

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssellke518790@ehrdirect.uhhospitals.org

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.

• Lake Hospital System Inc

  • Family Medicine Physician
  • Middlefield, OH
  • NPI 1952339996
  Medicare reassignment NPD
• Lake Hospital System, Inc

  • Urgent Care Clinic/Center
  • Chardon, OH
  • NPI 1689634966
  NPD
• Lake Hospital System, Inc.

  • Family Medicine Physician
  • Perry, OH
  • NPI 1174762512
  NPD

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1669948964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4652 W PARK DR",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262348",
            "telephone_number": "440-479-0345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CROCKER PARK BLVD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441456987",
            "telephone_number": "440-575-5762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Golden Gate Plz",
            "address_purpose": "LOCATION",
            "city": "Mayfield Heights",
            "state": "OH",
            "postal_code": "441243415",
            "country_code": "US",
            "telephone_number": "440-565-4344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5812 Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Parma",
            "state": "OH",
            "postal_code": "441293161",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11706 Clifton Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "OH",
            "postal_code": "441072018",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELLKE",
        "first_name": "SAMANTHA",
        "middle_name": "RAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.023777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bindu Sehgal, MD
• Breanna Seidl, RBT
• George R Seikel III, MD
• Elias Seise
• Roy E Seitz, MD
• Veronica S Seman, LISW
• Serendipity Pathways to Healing LLC
• Serenity Now Therapy LLC
• Dario Jorge Serra, MD
• Donna Sexton-Cicero, MD

• Family Nurse Practitioner in Westlake, OH
• Providers in Westlake, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.