Nicole Lee Samudio, APRN, CNP, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10216-33 Issued in WI

Practice address

701 Park Ave
Minneapolis, MN 55415-1623

Phone

(612) 873-6963

NPI assigned

May 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Lee Howe Former name

Medicare fee-for-service enrollment

Enrolled in WI, MN2 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 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Villagehealth DM LLCGroup PAC ID 2769812445, 161 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nsamudio658594@direct.centracare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/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.

• Villagehealth DM LLC

  • Case Management Agency
  • Denver, CO
  • NPI 1598273211

  MN, WI

  Medicare reassignment Care Compare group NPD
• Hennepin Healthcare System, Inc

  • Rehabilitation Hospital Unit
  • Minneapolis, MN
  • NPI 1033138136
  Medicare reassignment NPD
• Baldwin Area Medical Center, Inc.

  • Critical Access Hospital
  • Baldwin, WI
  • NPI 1467496133
  Medicare reassignment NPD
• Hennepin Healthcare System Inc

  • Specialty Pharmacy
  • Minneapolis, MN
  • NPI 1619567625
  NPD
• Hennepin Healthcare System, Inc

  • Psychiatric Hospital Unit
  • Minneapolis, MN
  • NPI 1356369524
  NPD
• Baldwin Area Medical Center Inc.

  • Clinic/Center
  • Spring Valley, WI
  • NPI 1164272324
  NPD
• Baldwin Area Medical Center, Inc.

  • Rural Health Clinic/Center
  • Baldwin, WI
  • NPI 1336228865
  NPD

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1831712355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-873-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-873-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUDIO",
        "first_name": "NICOLE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "APRN, CNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10216-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "HOWE",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alison Goulet Sample, FPMHNP
• Stacy Sampson, D.O.
• Margot Samson, MD
• Sophie Samson, MD
• Susan Silvasto Samson
• Robin Marie Samuel, OTR/L
• Caitlin Anne Samuels, MSW, LICSW
• Sarah Jane Howard Samuels, LICSW
• Samuelson Psychotherapy LLC
• Ellen Faye Samuelson, MA

• Family Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.
• 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.