SAMANTHA MARIE MCCORMACK APN
NPI 1053188391
Nurse Practitioner - Family in Montclair, NJ

Q: What is Samantha Mccormack's NPI number?

The NPI number for Samantha Mccormack is 1053188391. It was assigned to this individual provider in the NPPES registry on December 6, 2023.

Q: What is Samantha Mccormack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since December 06, 2023PECOS Enrolled

1 BAY AVE, MONTCLAIR, NJ 07042(973) 429-6096 Get Directions Write a Review

NPPES record last updated: October 15, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Samantha Marie Mccormack Apn NPPES

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

SAMANTHA MARIE MCCORMACK APN (NPI 1053188391) is an individual family provider in Montclair, New Jersey, licensed in New Jersey (26NJ14955300) and active in the NPI registry since December 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053188391

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSAMANTHA MARIE MCCORMACKCredential: APN

Location Address1 BAY AVEMontclair, NJ 07042-4837

Mailing Address168 Coeyman AveNutley, NJ 07110-1503 · (973) 930-8655

Phone(973) 429-6096

Sole ProprietorNo

Enumeration DateDecember 6, 2023

Last NPPES UpdateOctober 15, 2024

NPPES CertifiedOctober 15, 2024

✔ NPI 1053188391 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NJ · 26NJ14955300

1 BAY AVE, Montclair, NJ 07042

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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 Marie Mccormack Apn 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 07042 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

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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.

SAMRAH GHANI MD

Student in an Organized Health Care Education/Training Program

1 BAY AVE
MONTCLAIR, NJ 07042

Essex County (862) 333-4700

JACLYN TAYLOR SCHMITZ

Student in an Organized Health Care Education/Training Program

1 BAY AVE
MONTCLAIR, NJ 07042

Essex County (973) 429-6888

MYINT KYI M.D.

Anesthesiology

1 BAY AVE
MONTCLAIR, NJ 07042

Essex County (973) 429-6219

EDWARD PETRARCA LCSW

Social Worker (Clinical)

1 BAY AVE, MOUNTAINSIDE HOSPITAL
MONTCLAIR, NJ 07042

Essex County (973) 429-6813

ANN FRANCES VALLONE NURSE PRACTITIONER

Nurse Practitioner (Adult Health)

1 BAY AVE
MONTCLAIR, NJ 07042

Essex County (973) 429-6272

ANN SAMIR YASIN IBRAHIM

Student in an Organized Health Care Education/Training Program

1 BAY AVE
MONTCLAIR, NJ 07042

Essex County (862) 333-4700

GEORGE JAMES ZACH

Dentist

1 BAY AVE
MONTCLAIR, NJ 07042

Essex County (973) 429-6888

MRS. ESTHER D. BAXAM-SPENCE RN, MSN, CNNP

Nurse Practitioner (Neonatal)

1 BAY AVE
MONTCLAIR, NJ 07042

Essex County (973) 429-6991

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 Mccormack's NPI number?

The NPI number for Samantha Mccormack is 1053188391. It was assigned to this individual provider in the NPPES registry on December 6, 2023.

Where is Samantha Mccormack located?

Samantha Mccormack practices at 1 Bay Ave, Montclair, NJ 07042. The listed phone number is (973) 429-6096.

What is Samantha Mccormack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Samantha Mccormack enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Samantha Mccormack was last updated on October 15, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.