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DR. SAMUEL JESSE ANTHONY II DO
NPI 1154986024
Family Medicine in Roseville, MN

Active since May 07, 2019PECOS EnrolledAccepts Medicare Assignment
2401 FAIRVIEW AVE N STE 145, ROSEVILLE, MN 55113(888) 290-1209(833) 973-3529 Get Directions Write a Review

NPPES record last updated: July 23, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 29, 2025, Feb 17, 2023, May 7, 2019 (3 updates tracked since 2019).

About Dr. Samuel Jesse Anthony Ii Do NPPES

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

DR. SAMUEL JESSE ANTHONY II DO (NPI 1154986024) is an individual family medicine provider in Roseville, Minnesota, licensed in Minnesota (76012) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, is affiliated with Essentia Health Fosston, and is a graduate of Lincoln Mem Univ, Debusk Col Of Osteopathic Med (2019).

NPPES Registry Identity

NPI1154986024
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SAMUEL JESSE ANTHONY IICredential: DO
Location Address2401 FAIRVIEW AVE N STE 145Roseville, MN 55113-2710
Mailing Address20515 Aspen DrGrand Rapids, MN 55744-4792
Phone(888) 290-1209
Fax(833) 973-3529
Sole ProprietorYes
Medical School CMSLincoln Mem Univ, Debusk Col Of Osteopathic MedGraduated 2019
Enumeration DateMay 7, 2019
Last NPPES UpdateJuly 23, 20253 updates tracked since enumeration
NPPES CertifiedJuly 23, 2025
✔ NPI 1154986024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MN · 76012
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2401 FAIRVIEW AVE N STE 145, Roseville, MN 55113
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Samuel Jesse Anthony Ii Do 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 ID6800263294
PECOS Enrollment IDI20240503002699
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 Reassignments

3

Medicare enrollment records show Samuel Anthony reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Grand Itasca Clinic And Hospital
154 mi
General Acute Care Hospital
1601 GOLF COURSE RD
Grand Rapids, MN 55744
  • Reassigned Medicare billing, Minnesota enrollment
  • 555 clinicians in this Medicare group
NPI 1669426631 (218) 326-3401
First Care Medical Services
203 mi
Rural Health
121 CENTRAL ST W
Bagley, MN 56621
  • Reassigned Medicare billing, Minnesota enrollment
  • Also billed through NPI 1497850119 (Minnesota)
  • 91 clinicians in this Medicare group
NPI 1790861649 (218) 694-6281
Ecm Health Group LLC
763 mi
Obstetrics & Gynecology
1751 VETERANS DR
Florence, AL 35630
  • Reassigned Medicare billing, Alabama enrollment
  • 209 clinicians in this Medicare group
NPI 1346588852 (256) 767-0081

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
112 services28 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
42 services31 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
18 services15 patients

Hospital Affiliations CMS Care Compare

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

Essentia Health Fosston

Critical Access Hospitals · Fosston, MN
OwnershipVoluntary non-profit - Private
CMS Certification Number241357
Location900 Hilligoss Boulevard SEFosston, MN 56542 · Polk County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55113 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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 4

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

JULIE ANNE ANDERSSON PA
Physician Assistant
2401 FAIRVIEW AVE N STE 145
ROSEVILLE, MN 55113
Ramsey County (888) 290-1209
DR. KATHLEEN WAI GERN WOO-RIPPE M.D.
Family Medicine
2401 FAIRVIEW AVE N STE 145
ROSEVILLE, MN 55113
Ramsey County (888) 290-1209
LAURA C KAHLBAUGH RN
Registered Nurse
2401 FAIRVIEW AVE N STE 145
ROSEVILLE, MN 55113
Ramsey County (888) 290-1209
LEAH D ATKINSON FNP
Nurse Practitioner (Family)
2401 FAIRVIEW AVE N STE 145
ROSEVILLE, MN 55113
Ramsey County (888) 290-1209

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 Anthony's NPI number?

The NPI number for Samuel Anthony is 1154986024. It was assigned to this individual provider in the NPPES registry on May 7, 2019.

Where is Samuel Anthony located?

Samuel Anthony practices at 2401 Fairview Ave N Ste 145, Roseville, MN 55113. The listed phone number is (888) 290-1209.

What is Samuel Anthony's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Samuel Anthony enrolled in Medicare?

Yes. Samuel Anthony is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Samuel Anthony's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Anthony reassigns Medicare benefits to 3 organizations: Grand Itasca Clinic And Hospital (Grand Rapids, MN), First Care Medical Services (Bagley, MN) and Ecm Health Group LLC (Florence, AL). Each 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 Anthony's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samuel Anthony accept?

Health plans from Sanford Health Plan list Samuel Anthony 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.

Is Samuel Anthony affiliated with any hospitals?

According to CMS data, Samuel Anthony is affiliated with Essentia Health Fosston.

When was this NPI record last updated?

The NPPES record for Samuel Anthony was last updated on July 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.