Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. SAMANTHA GWEN BROCK MD
NPI 1104323880
Surgery in Nellis Afb, NV

Q: What is Samantha Brock's NPI number?

The NPI number for Samantha Brock is 1104323880. It was assigned to this individual provider in the NPPES registry on April 10, 2018.

Q: What is Samantha Brock's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Brock was last updated on August 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days 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 10, 2018PECOS Enrolled

4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191(702) 653-3898 Get Directions Write a Review

NPPES record last updated: August 12, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 12, 2026, Sep 5, 2024, Nov 21, 2023 and 2 more (5 updates tracked since 2018).

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About Dr. Samantha Gwen Brock Md NPPES

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

DR. SAMANTHA GWEN BROCK MD (NPI 1104323880) is an individual surgery provider in Nellis Afb, Nevada, licensed in Indiana (01083831A) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1104323880

Entity TypeIndividualFemale

Primary Taxonomy208600000X

Provider Legal NameDR. SAMANTHA GWEN BROCKCredential: MD

Location Address4700 LAS VEGAS BLVD NNellis Afb, NV 89191-6600

Mailing Address4700 Las Vegas Blvd NNellis Afb, NV 89191-6600 · (702) 653-3898

Phone(702) 653-3898

Sole ProprietorYes

Enumeration DateApril 10, 2018

Last NPPES UpdateAugust 12, 20265 updates tracked since enumeration

NPPES CertifiedAugust 12, 2026

✔ NPI 1104323880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in IN · 01083831A

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

4700 LAS VEGAS BLVD N, Nellis Afb, NV 89191

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Secondary Practice Locations 5

Location 151ST MDG, Unit 2060, 51st Medical GroupAPO, AP 96278-2060 · Phone (315) 784-0196

Location 24881 Sugar Maple DrWright Patterson AFB, OH 45433-5529 · Phone (937) 257-8715

Location 3128 E. Apple St., WCHE 7th FloorDayton, OH 45409 · Phone (937) 208-4953

Location 41060 W Perimeter Rd # RJb Andrews, MD 20762-6602 · Phone (240) 612-2464

Location 51800 W Charleston BlvdLas Vegas, NV 89102-2386 · Phone (702) 383-2000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Samantha Gwen Brock Md 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 89191 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

$71.14 typical visit price

range $18.27 – $140.96

Typical copayment $17.78 (range $4.56 – $35.24)

Most-billed visit code 99213

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.

DR. DEBRA A KOENIGSBERGER MD

Integrative Medicine