SAMANTHA JERUSAL
NPI 1013610971
Nurse Practitioner - Pediatrics in Chicago, IL

Active since March 22, 2023PECOS Enrolled
2418 W DIVISION ST, CHICAGO, IL 60622(312) 666-3494 Get Directions Write a Review

NPPES record last updated: September 5, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 5, 2023, Mar 22, 2023 (2 updates tracked since 2023).

About Samantha Jerusal NPPES

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

SAMANTHA JERUSAL (NPI 1013610971) is an individual pediatrics provider in Chicago, Illinois, licensed in Illinois (209.028195) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013610971
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameSAMANTHA JERUSAL
Location Address2418 W DIVISION STChicago, IL 60622-2940
Mailing Address2418 W Division StChicago, IL 60622-2940 · (312) 666-3494
Sole ProprietorNo
Enumeration DateMarch 22, 2023
Last NPPES UpdateSeptember 5, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 5, 2023
NPI 1013610971 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License Licensed in IL · 209.028195
Also ListedRegistered Nurse · PediatricsTaxonomy 163WP0200X · License 501051 (OH)
2418 W DIVISION ST, Chicago, IL 60622

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Samantha Jerusal is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60622 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

Family Medicine
2418 W DIVISION ST
CHICAGO, IL 60622
Internal Medicine
2418 W DIVISION ST
CHICAGO, IL 60622
Pediatrics
2418 W DIVISION ST, ERIE FAMILY HEALTH CENTER
CHICAGO, IL 60622
Nurse Practitioner (Pediatrics)
2418 W DIVISION ST
CHICAGO, IL 60622
Clinic/Center (Community Health)
2418 W DIVISION ST
CHICAGO, IL 60622
Family Medicine
2418 W DIVISION ST
CHICAGO, IL 60622
Social Worker
2418 W DIVISION ST
CHICAGO, IL 60622
Pediatrics
2418 W DIVISION ST
CHICAGO, IL 60622

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Jerusal's NPI number?

The NPI number for Samantha Jerusal is 1013610971. It was assigned to this individual provider in the NPPES registry on March 22, 2023.

Where is Samantha Jerusal located?

Samantha Jerusal practices at 2418 W Division St, Chicago, IL 60622. The listed phone number is (312) 666-3494.

What is Samantha Jerusal's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Samantha Jerusal enrolled in Medicare?

Yes. Samantha Jerusal is registered in the Medicare PECOS enrollment system.

What insurance does Samantha Jerusal accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Samantha Jerusal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samantha Jerusal was last updated on September 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.