SAMANTHA RAE CARLSON APRN, FNP-BC
NPI 1164316352
Nurse Practitioner - Family in Rockford, IL
About Samantha Rae Carlson Aprn, Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMANTHA RAE CARLSON APRN, FNP-BC (NPI 1164316352) is an individual family provider in Rockford, Illinois, licensed in Illinois (209031429) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS, is affiliated with Saint Anthony Medical Center, and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Accepted 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
Samantha Rae Carlson Aprn, Fnp-bc 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 Carlson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Peoria, IL 61615
- Reassigned Medicare billing, Illinois enrollment
- 2,944 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Saint Anthony Medical Center
Acute Care Hospitals · Rockford, ILPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 61108 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Carlson's NPI number?
The NPI number for Samantha Carlson is 1164316352. It was assigned to this individual provider in the NPPES registry on June 4, 2025.
Where is Samantha Carlson located?
Samantha Carlson practices at 5666 E State St, Rockford, IL 61108. The listed phone number is (815) 226-2000.
What is Samantha Carlson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Samantha Carlson enrolled in Medicare?
Yes. Samantha Carlson 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 Carlson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Carlson reassigns Medicare benefits to Osf Multi-Specialty Group (Peoria, IL). 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 Carlson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Samantha Carlson accept?
Health plans from Dean Health Plan list Samantha Carlson 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 Samantha Carlson affiliated with any hospitals?
According to CMS data, Samantha Carlson is affiliated with Saint Anthony Medical Center.
When was this NPI record last updated?
The NPPES record for Samantha Carlson was last updated on October 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Samantha Rae Carlson, APRN, FNP-BC · NPI 1164316352
Family physician in Rockford, Illinois. Individual provider, active in the CMS NPPES registry since June 4, 2025.
## Identity
- **NPI:** 1164316352 (Entity type: Individual)
- **Enumerated:** June 4, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 209031429 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 5666 E STATE ST, Rockford, IL 61108-2425
- **Phone:** (815) 226-2000
## 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:** Osf Multi-Specialty Group (NPI 1154908929, Peoria, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** October 15, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1164316352) · Data from the CMS NPPES public registry.