SAMUEL SECORD
NPI 1093324022
Marriage & Family Therapist in Burnsville, MN
About Samuel Secord NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL SECORD (NPI 1093324022) is an individual marriage & family therapist in Burnsville, Minnesota, licensed in Minnesota (4474) and active in the NPI registry since July 2020. He 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)
Samuel Secord is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Samuel Secord reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Burnsville, MN 55337
- Reassigned Medicare billing, Minnesota enrollment
- 27 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.
Other Providers at the Same Location NPPES 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BURNSVILLE, MN 55337
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 Samuel Secord's NPI number?
The NPI number for Samuel Secord is 1093324022. It was assigned to this individual provider in the NPPES registry on July 27, 2020.
Where is Samuel Secord located?
Samuel Secord practices at 11990 Portland Ave, Burnsville, MN 55337. The listed phone number is (763) 310-6882.
What is Samuel Secord's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Samuel Secord enrolled in Medicare?
Yes. Samuel Secord is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Samuel Secord's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Secord reassigns Medicare benefits to Ashlee Secord (Burnsville, MN). 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 Samuel Secord's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Samuel Secord accept?
Health plans from HealthPartners list Samuel Secord 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 Samuel Secord was last updated on August 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Samuel Secord · NPI 1093324022
Marriage & Family Therapist provider in Burnsville, Minnesota. Individual provider, active in the CMS NPPES registry since July 27, 2020.
## Identity
- **NPI:** 1093324022 (Entity type: Individual)
- **Enumerated:** July 27, 2020
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **State license:** 4474 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 11990 PORTLAND AVE, Burnsville, MN 55337-1516
- **Phone:** (763) 310-6882
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Ashlee Secord (NPI 1073902177, Burnsville, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 6, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1093324022) · Data from the CMS NPPES public registry.