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ELIZABETH SAMUEL LICSW
NPI 1164281713
Social Worker - Clinical in Eden Prairie, MN

Active since March 18, 2024PECOS Enrolled
6442 CITY WEST PKWY STE 200, EDEN PRAIRIE, MN 55344(763) 318-2788 Get Directions Write a Review

NPPES record last updated: August 14, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Elizabeth Samuel Licsw NPPES

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

ELIZABETH SAMUEL LICSW (NPI 1164281713) is an individual clinical provider in Eden Prairie, Minnesota, licensed in Wisconsin (11880-123) and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164281713
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameELIZABETH SAMUELCredential: LICSW
Location Address6442 CITY WEST PKWY STE 200Eden Prairie, MN 55344-2809
Mailing Address6442 City West Pkwy Ste 200Eden Prairie, MN 55344-2809
Phone(763) 318-2788
Sole ProprietorYes
Enumeration DateMarch 18, 2024
Last NPPES UpdateAugust 14, 2024
NPPES CertifiedAugust 14, 2024
✔ NPI 1164281713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in WI · 11880-123✔ Licensed in MN · 29063
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
6442 CITY WEST PKWY STE 200, Eden Prairie, MN 55344
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elizabeth Samuel Licsw 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.

Medicare Billing Reassignment

Medicare enrollment records show Elizabeth Samuel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Rogers Memorial Hospital Incorporated
277 mi
Psychiatric Hospital
34700 VALLEY RD
Oconomowoc, WI 53066
  • Reassigned Medicare billing, Wisconsin enrollment
  • 99 clinicians in this Medicare group
NPI 1053329581 (800) 767-4411

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55344 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
$0.00 typical visit price
range $56.00 – $168.28
Typical copayment $0.00 (range $14.00 – $42.07)
Most-billed visit code NA
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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 3

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

OLIVIA WELLS
Nurse Practitioner (Psychiatric/Mental Health)
6442 CITY WEST PKWY STE 200
EDEN PRAIRIE, MN 55344
Hennepin County (833) 308-5887
ROGERS MEMORIAL HOSPITAL INCORPORATED
Clinic/Center
6442 CITY WEST PKWY STE 200
EDEN PRAIRIE, MN 55344
Hennepin County (800) 767-4411
DR. DANIEL ELCHERT PHD
Psychologist (Clinical)
6442 CITY WEST PKWY STE 200
EDEN PRAIRIE, MN 55344
Hennepin County (763) 318-2800

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 Elizabeth Samuel's NPI number?

The NPI number for Elizabeth Samuel is 1164281713. It was assigned to this individual provider in the NPPES registry on March 18, 2024.

Where is Elizabeth Samuel located?

Elizabeth Samuel practices at 6442 City West Pkwy Ste 200, Eden Prairie, MN 55344. The listed phone number is (763) 318-2788.

What is Elizabeth Samuel's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Elizabeth Samuel enrolled in Medicare?

Yes. Elizabeth Samuel is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Elizabeth Samuel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elizabeth Samuel reassigns Medicare benefits to Rogers Memorial Hospital Incorporated (Oconomowoc, WI). 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 Elizabeth Samuel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Elizabeth Samuel accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners, Medica and UnitedHealthcare list Elizabeth Samuel 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.

When was this NPI record last updated?

The NPPES record for Elizabeth Samuel was last updated on August 14, 2024. 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.