SAMANTHA JERUSAL
NPI 1013610971
Nurse Practitioner - Pediatrics in Chicago, IL
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
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Samantha Jerusal is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Samantha Jerusal reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Chicago, IL 60622
- Reassigned Medicare billing, Illinois enrollment
- 383 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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.
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.
Which organization bills Medicare for Samantha Jerusal's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Jerusal reassigns Medicare benefits to Erie Family Health Center Inc (Chicago, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samantha Jerusal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Samantha Jerusal accept?
Health plans from Ambetter Health and Ambetter Health of Delaware 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 3 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.
# Samantha Jerusal · NPI 1013610971
Pediatrics physician in Chicago, Illinois. Individual provider, active in the CMS NPPES registry since March 22, 2023.
## Identity
- **NPI:** 1013610971 (Entity type: Individual)
- **Enumerated:** March 22, 2023
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** 209.028195 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 2418 W DIVISION ST, Chicago, IL 60622-2940
- **Phone:** (312) 666-3494
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Erie Family Health Center Inc (NPI 1700144243, Chicago, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 5, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1013610971) · Data from the CMS NPPES public registry.