MR. RICHARD GABRIEL SAMEDRA PMHNP-BC
NPI 1093561904
Nurse Practitioner - Psychiatric/Mental Health in Anaheim, CA

Q: What is Richard Samedra's NPI number?

The NPI number for Richard Samedra is 1093561904. It was assigned to this individual provider in the NPPES registry on April 30, 2024.

Q: What is Richard Samedra's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Richard Samedra was last updated on April 17, 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.

Active since April 30, 2024PECOS EnrolledAccepts Medicare Assignment

1720 W BALL RD STE 4C, ANAHEIM, CA 92804(714) 683-1472(714) 683-1473 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 3, 2025, Jul 22, 2024, Apr 30, 2024 (3 updates tracked since 2024).

On this page

About Mr. Richard Gabriel Samedra Pmhnp-bc NPPES

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

MR. RICHARD GABRIEL SAMEDRA PMHNP-BC (NPI 1093561904) is an individual psychiatric/mental health provider in Anaheim, California, licensed in California (95030301) and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS, maintains a secondary practice location in Placentia, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1093561904

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameMR. RICHARD GABRIEL SAMEDRACredential: PMHNP-BC

Location Address1720 W BALL RD STE 4CAnaheim, CA 92804-5591

Mailing Address123 Orange Grove AvePlacentia, CA 92870-4848 · (949) 566-4308 · Fax (714) 683-1473

Phone(714) 683-1472

Fax(714) 683-1473

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateApril 30, 2024

Last NPPES UpdateApril 17, 20253 updates tracked since enumeration

NPPES CertifiedApril 17, 2025

✔ NPI 1093561904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95030301

1720 W BALL RD STE 4C, Anaheim, CA 92804

Open in Google Maps ↗

Secondary Practice Location 1

Location 1123 Orange Grove AvePlacentia, CA 92870-4848 · Phone (949) 566-4308

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Richard Gabriel Samedra Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163957176

PECOS Enrollment IDI20241127004205

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 92804 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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 7

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

MINA CHERIKI RN, PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)