SAMANTHA SHOSHANA PETRILLO AGACNP-BC
NPI 1003782228
Nurse Practitioner - Adult Health in Fort Lauderdale, FL

Q: What is Samantha Petrillo's NPI number?

The NPI number for Samantha Petrillo is 1003782228. It was assigned to this individual provider in the NPPES registry on October 14, 2025.

Q: What is Samantha Petrillo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Petrillo was last updated on January 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 14, 2025PECOS EnrolledAccepts Medicare Assignment

1601 S ANDREWS AVE FL 3, FORT LAUDERDALE, FL 33316(954) 763-6655(954) 763-6799 Get Directions Write a Review

NPPES record last updated: January 26, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Samantha Shoshana Petrillo Agacnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA SHOSHANA PETRILLO AGACNP-BC (NPI 1003782228) is an individual adult health provider in Fort Lauderdale, Florida, licensed in Florida (APRN11042570) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS, is affiliated with Broward Health Medical Center, and is a graduate of University Of Miami, Lm Miller School Of Medicine (2025).

NPPES Registry Identity

NPI1003782228

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameSAMANTHA SHOSHANA PETRILLOCredential: AGACNP-BC

Location Address1601 S ANDREWS AVE FL 3Fort Lauderdale, FL 33316-2509

Mailing Address1608 Se 3rd Ave Fl 3Fort Lauderdale, FL 33316-2564 · (954) 763-6655 · Fax (954) 763-6799

Phone(954) 763-6655

Fax(954) 763-6799

Sole ProprietorNo

Medical School CMSUniversity Of Miami, Lm Miller School Of MedicineGraduated 2025

Enumeration DateOctober 14, 2025

Last NPPES UpdateJanuary 26, 2026

NPPES CertifiedJanuary 26, 2026

✔ NPI 1003782228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in FL · APRN11042570

Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License 11042570 (FL)

1601 S ANDREWS AVE FL 3, Fort Lauderdale, FL 33316

Open in Google Maps ↗

Other Identifiers 1

Medicaid129062900FL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samantha Shoshana Petrillo Agacnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395237846

PECOS Enrollment IDI20251122000957

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Broward Health Medical Center

Acute Care Hospitals · Fort Lauderdale, FL

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100039

Location1600 S Andrews AveFort Lauderdale, FL 33316 · Broward County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33316 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$91.69 typical visit price

range $58.56 – $179.05

Typical copayment $22.92 (range $14.64 – $44.76)

Most-billed visit code 99203

Established Patient

$103.21 typical visit price

range $18.44 – $144.68

Typical copayment $25.80 (range $4.61 – $36.17)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELLY MELISSA ROLAND APRN

Nurse Practitioner (Family)