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SAMANTHA NICOLE PETTY PMHNP
NPI 1174248405
Nurse Practitioner - Psychiatric/Mental Health in Sterling, IL

Active since October 10, 2022PECOS EnrolledAccepts Medicare Assignment
1808 19TH AVE, STERLING, IL 61081(815) 718-2344 Get Directions Write a Review

NPPES record last updated: October 10, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Samantha Nicole Petty Pmhnp NPPES

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

SAMANTHA NICOLE PETTY PMHNP (NPI 1174248405) is an individual psychiatric/mental health provider in Sterling, Illinois, licensed in Illinois (209.026134) and active in the NPI registry since October 2022. She is enrolled in Medicare PECOS, is affiliated with Katherine Shaw Bethea Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1174248405
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameSAMANTHA NICOLE PETTYCredential: PMHNP
Location Address1808 19TH AVESterling, IL 61081-1676
Mailing Address1808 19th AveSterling, IL 61081-1676 · (815) 718-2344
Phone(815) 718-2344
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateOctober 10, 2022
NPPES CertifiedOctober 9, 2022
✔ NPI 1174248405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in IL · 209.026134
1808 19TH AVE, Sterling, IL 61081
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.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 Nicole Petty Pmhnp 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 ID2668845306
PECOS Enrollment IDI20230228003214
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

5

Medicare enrollment records show Samantha Petty reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ksb Medical Group, Inc.
10 mi
Clinic/Center
215 E 1ST ST, STE 101
Dixon, IL 61021
  • Reassigned Medicare billing, Illinois enrollment
  • 130 clinicians in this Medicare group
NPI 1629046115 (815) 285-5973
Katherine Shaw Bethea Hospital
10 mi
General Acute Care Hospital
403 E 1ST ST
Dixon, IL 61021
  • Reassigned Medicare billing, Illinois enrollment
  • 64 clinicians in this Medicare group
NPI 1427043546 (815) 288-5521
Osf Multi-Specialty Group
70 mi
Internal Medicine
8600 N STATE ROUTE 91
Peoria, IL 61615
  • Reassigned Medicare billing, Illinois enrollment
  • 2,944 clinicians in this Medicare group
NPI 1154908929 (309) 683-5050
Access Telecare, PLLC
735 mi
Internal Medicine
1717 MAIN ST STE 5850
Dallas, TX 75201
  • Reassigned Medicare billing, Illinois enrollment
  • 115 clinicians in this Medicare group
NPI 1013303080 (972) 449-0540
Forefront-Rosenzweig Medical Services Professional Corporation
735 mi
Psychiatry
1717 MAIN ST STE 5850
Dallas, TX 75201
  • Reassigned Medicare billing, Illinois enrollment
  • 34 clinicians in this Medicare group
NPI 1588101745 (972) 449-0540

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.

Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth G0408
A follow-up inpatient consultation is a service where your doctor checks on your health progress after initial treatment. It's complex and typically takes about 35 minutes via telehealth, which means you'll talk to your doctor remotely, using technology.
26 services15 patients
Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth G0427
A Telehealth consultation is a virtual visit where you can discuss your health concerns with a healthcare provider from the comfort of your home. In this process, which typically lasts 70 minutes or more, the provider can assess, diagnose, and offer treatment options for your condition using communication technology.
25 services23 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
23 services12 patients

Hospital Affiliations CMS Care Compare

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

Katherine Shaw Bethea Hospital

Acute Care Hospitals · Dixon, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140012
Location403 E 1st StDixon, IL 61021 · Lee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61081 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

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 Petty's NPI number?

The NPI number for Samantha Petty is 1174248405. It was assigned to this individual provider in the NPPES registry on October 10, 2022.

Where is Samantha Petty located?

Samantha Petty practices at 1808 19th Ave, Sterling, IL 61081. The listed phone number is (815) 718-2344.

What is Samantha Petty's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Samantha Petty enrolled in Medicare?

Yes. Samantha Petty 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 Samantha Petty's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Petty reassigns Medicare benefits to 5 organizations: Ksb Medical Group, Inc. (Dixon, IL), Katherine Shaw Bethea Hospital (Dixon, IL), Osf Multi-Specialty Group (Peoria, IL), Access Telecare, PLLC (Dallas, TX) and Forefront-Rosenzweig Medical Services Professional Corporation (Dallas, TX). 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 Samantha Petty's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samantha Petty accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Samantha Petty 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 Petty affiliated with any hospitals?

According to CMS data, Samantha Petty is affiliated with Katherine Shaw Bethea Hospital.

When was this NPI record last updated?

The NPPES record for Samantha Petty was last updated on October 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.