SAMANTHA WILSON
NPI 1164081915
Nurse Practitioner - Women's Health in Fairfax, VA
About Samantha Wilson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMANTHA WILSON (NPI 1164081915) is an individual women's health provider in Fairfax, Virginia, licensed in Virginia (0024177383) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of University Of Cincinnati College Of Medicine (2018).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 3
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
Samantha Wilson 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.
Medicare Billing Reassignment
Medicare enrollment records show Samantha Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fulton, MD 20759
- Reassigned Medicare billing, District of Columbia enrollment
- Medicare enrollment name: Capital Womens Care LLC
- 186 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.
Areas of Expertise CMS Part B claims
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 22030 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FAIRFAX, VA 22030
FAIRFAX, VA 22030
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 Samantha Wilson's NPI number?
The NPI number for Samantha Wilson is 1164081915. It was assigned to this individual provider in the NPPES registry on June 6, 2019.
Where is Samantha Wilson located?
Samantha Wilson practices at 10521 Rosehaven St Ste Ll100, Fairfax, VA 22030. The listed phone number is (703) 281-5000.
What is Samantha Wilson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.
Is Samantha Wilson enrolled in Medicare?
Yes. Samantha Wilson 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 organization bills Medicare for Samantha Wilson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Wilson reassigns Medicare benefits to Capital Women's Care, L.L.C. (Fulton, MD). 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 Samantha Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Samantha Wilson was last updated on December 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Samantha Wilson · NPI 1164081915
Women's Health physician in Fairfax, Virginia. Individual provider, active in the CMS NPPES registry since June 6, 2019.
## Identity
- **NPI:** 1164081915 (Entity type: Individual)
- **Enumerated:** June 6, 2019
- **Primary specialty:** Nurse Practitioner - Women's Health · taxonomy 363LW0102X
- **State license:** 0024177383 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 10521 ROSEHAVEN ST STE LL100, Fairfax, VA 22030-2877
- **Phone:** (703) 281-5000 · **Fax:** (703) 255-0765
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Capital Women's Care, L.L.C. (NPI 1679534069, Fulton, MD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Cincinnati College Of Medicine, class of 2018
## Record status
- **NPPES last updated:** December 5, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1164081915) · Data from the CMS NPPES public registry.