SAMANTHA REEDY
NPI 1134916190
Nurse Practitioner in Kenosha, WI

Q: What is Samantha Reedy's NPI number?

The NPI number for Samantha Reedy is 1134916190. It was assigned to this individual provider in the NPPES registry on April 23, 2025.

Q: What is Samantha Reedy's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Reedy was last updated on April 23, 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 23, 2025PECOS EnrolledAccepts Medicare Assignment

7401 104TH AVE STE 110, KENOSHA, WI 53142(262) 764-5595(262) 764-9314 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Samantha Reedy NPPES

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

SAMANTHA REEDY (NPI 1134916190) is an individual nurse practitioner in Kenosha, Wisconsin, licensed in Wisconsin (16734) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS, is affiliated with Froedtert South Inc., and maintains a secondary practice location in Burlington.

NPPES Registry Identity

NPI1134916190

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameSAMANTHA REEDY

Location Address7401 104TH AVE STE 110Kenosha, WI 53142-7845

Mailing Address7401 104th Ave Ste 110Kenosha, WI 53142-7845 · (262) 764-5595 · Fax (262) 764-9314

Phone(262) 764-5595

Fax(262) 764-9314

Sole ProprietorNo

Medical School CMSRush Medical College Of Rush UniversityGraduated 2024

Enumeration DateApril 23, 2025

NPPES CertifiedApril 23, 2025

✔ NPI 1134916190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in WI · 16734

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

7401 104TH AVE STE 110, Kenosha, WI 53142

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Secondary Practice Location 1

Location 11757B Milwaukee AveBurlington, WI 53105-9458 · Phone (262) 764-5595

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Network Health, UnitedHealthcare.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

Samantha Reedy 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 ID2567971294

PECOS Enrollment IDI20250603003490

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Froedtert South Inc.

Acute Care Hospitals · Pleasant Prairie, WI

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number520021

Location9555 76th StPleasant Prairie, WI 53158 · Kenosha County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53142 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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 12

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

CLAY JAMISON FRANK M.D.

Orthopaedic Surgery (Orthopaedic Surgery of the Spine)