Samantha Joanne Peszko, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704320253 Issued in MI

Practice address

3601 W 13 Mile Rd Ste Ec
Royal Oak, MI 48073-6712

Phone

(248) 898-5058

Fax

(248) 898-2017

NPI assigned

Feb 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

Nurse Practitioner

Education

University of Michigan Medical School, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Wound Care and Hyperbaric Medicine of Michigan PCGroup PAC ID 0749590743, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.37 of 100Reported as group

Quality

66.73

Promoting interoperability

100

Improvement activities

40

Cost

70.98

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: speszko1086078@direct.hfhs.org
• FHIR API: https://fhir.meditouchehr.com/api/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.

• Advanced Wound Care and Hyperbaric Medicine of Michigan PC

  • Internal Medicine Physician
  • West Bloomfield, MI
  • NPI 1093184129
  Medicare reassignment Care Compare group NPD
• Jose S Evangelista III MD PC

  • Internal Medicine Physician
  • West Bloomfield, MI
  • NPI 1871998385
  Medicare reassignment NPD
• Michigan Canton Cardiology Associates PLLC

  • Interventional Cardiology Physician
  • Canton, MI
  • NPI 1003319096
  Medicare reassignment NPD
• A. Peter Evangelista, MD, PC

  • Internal Medicine Physician
  • Livonia, MI
  • NPI 1538616008
  NPD (past)

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1922690577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1865",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD STE EC",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-5058",
            "fax_number": "248-898-2017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 N Lafayette St",
            "address_purpose": "LOCATION",
            "city": "South Lyon",
            "state": "MI",
            "postal_code": "481782048",
            "country_code": "US",
            "telephone_number": "248-437-1744",
            "fax_number": "248-437-3245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5756 S Weed Rd",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MI",
            "postal_code": "481705816",
            "country_code": "US",
            "telephone_number": "313-657-1938",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4949 Coolidge Hwy # G",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480731026",
            "country_code": "US",
            "telephone_number": "248-655-3147",
            "fax_number": "248-655-3148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PESZKO",
        "first_name": "SAMANTHA",
        "middle_name": "JOANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704320253",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704320253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04492)
• Elana Kathryn Perry
• Jean Lucille Perry, LMSW
• Nicole L Perry, FNP-C
• Personal Transformations
• Ashley Peters, OD
• James Lee Peters, MD
• Kenneth M Peters, MD
• Taylor Peters
• Cara Peterson, MSN, BSN, FNP-C, RN

• Family Nurse Practitioner in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.