1. Home
  2. Directory
  3. Nevada
  4. Las Vegas
  5. Nurse Practitioner
  6. NPI Profile

IMELDA CHI SAM NP-C
NPI 1053819755
Nurse Practitioner - Primary Care in Las Vegas, NV

Active since January 28, 2018PECOS Enrolled
3968 N RANCHO DR, LAS VEGAS, NV 89130(702) 791-9020(702) 791-9261 Get Directions Write a Review

NPPES record last updated: July 5, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Imelda Chi Sam Np-c NPPES

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

IMELDA CHI SAM NP-C (NPI 1053819755) is an individual primary care provider in Las Vegas, Nevada, licensed in Nevada (APRN002763) and active in the NPI registry since January 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053819755
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameIMELDA CHI SAMCredential: NP-C
Location Address3968 N RANCHO DRLas Vegas, NV 89130-3412
Mailing Address6900 N Pecos RdNorth Las Vegas, NV 89086-4400 · (702) 791-9000
Phone(702) 791-9020
Fax(702) 791-9261
Sole ProprietorNo
Enumeration DateJanuary 28, 2018
Last NPPES UpdateJuly 5, 2023
NPPES CertifiedJuly 5, 2023
✔ NPI 1053819755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in NV · APRN002763
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License APRN00002763 (NV)
3968 N RANCHO DR, Las Vegas, NV 89130
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Imelda Chi Sam Np-c 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.

Medicare Billing Reassignment

Medicare enrollment records show Imelda Sam reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

R Muthaiah MD PC
2.2 mi
Internal Medicine
5061 N RAINBOW BLVD STE 180
Las Vegas, NV 89130
  • Reassigned Medicare billing, Nevada enrollment
  • 5 clinicians in this Medicare group
NPI 1124170493 (702) 220-8001

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 89130 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
$88.51 typical visit price
range $57.07 – $173.24
Typical copayment $22.12 (range $14.26 – $43.31)
Most-billed visit code 99203
Established Patient
$100.60 typical visit price
range $18.27 – $140.96
Typical copayment $25.15 (range $4.56 – $35.24)
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 8

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

DR. KRISTEN LANGLOIS D.O.
Psychiatry & Neurology (Psychiatry)
3968 N RANCHO DR
LAS VEGAS, NV 89130
Clark County (702) 791-9020
SHERRI BOYD LSW, MSW
Social Worker
3968 N RANCHO DR
LAS VEGAS, NV 89130
Clark County (702) 396-7597
JHANI HARRIS
Social Worker (Clinical)
3968 N RANCHO DR
LAS VEGAS, NV 89130
Clark County (219) 680-8630
TONY ANTRANIK SARKISSIAN MD
Family Medicine
3968 N RANCHO DR
LAS VEGAS, NV 89130
Clark County (702) 791-9020
MRS. MARIA EUNICE D TAN NP
Nurse Practitioner (Family)
3968 N RANCHO DR
LAS VEGAS, NV 89130
Clark County (702) 791-9020
DR. SARAH PHILLIPS RAYMOND PHD
Psychologist (Clinical)
3968 N RANCHO DR
LAS VEGAS, NV 89130
Clark County (702) 791-9020
DANIELLE SMALL
Pharmacist
3968 N RANCHO DR
LAS VEGAS, NV 89130
Clark County (702) 791-9000
MARJORIE ANN MALLECK M.D.
Internal Medicine
3968 N RANCHO DR
LAS VEGAS, NV 89130
Clark County (702) 791-9020

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 Imelda Sam's NPI number?

The NPI number for Imelda Sam is 1053819755. It was assigned to this individual provider in the NPPES registry on January 28, 2018.

Where is Imelda Sam located?

Imelda Sam practices at 3968 N Rancho Dr, Las Vegas, NV 89130. The listed phone number is (702) 791-9020.

What is Imelda Sam's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Imelda Sam enrolled in Medicare?

Yes. Imelda Sam is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Imelda Sam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Imelda Sam reassigns Medicare benefits to R Muthaiah MD PC (Las Vegas, NV). 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 Imelda Sam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Imelda Sam was last updated on July 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.