SAMANTHA MARIE GUDGEON NURSE PRACTITIONER
NPI 1174443261
Nurse Practitioner in Coon Rapids, MN

Q: What is Samantha Gudgeon's NPI number?

The NPI number for Samantha Gudgeon is 1174443261. It was assigned to this individual provider in the NPPES registry on July 17, 2026. The provider is also known as Samantha Marie Pitts.

Q: What is Samantha Gudgeon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Gudgeon was last updated on August 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since July 17, 2026PECOS Enrolled

4040 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN 55433(763) 427-9980(763) 236-8903 Get Directions Write a Review

NPPES record last updated: August 12, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 12, 2026, Jul 17, 2026 (2 updates tracked since 2026).

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About Samantha Marie Gudgeon Nurse Practitioner NPPES

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

SAMANTHA MARIE GUDGEON NURSE PRACTITIONER (NPI 1174443261) is an individual nurse practitioner in Coon Rapids, Minnesota, licensed in Minnesota (14503) and active in the NPI registry since July 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2026).

NPPES Registry Identity

NPI1174443261

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameSAMANTHA MARIE GUDGEONCredential: NURSE PRACTITIONER

Location Address4040 COON RAPIDS BLVD NW STE 120Coon Rapids, MN 55433-4568

Mailing Address2925 Chicago AveMinneapolis, MN 55407-1321 · (612) 262-9000

Phone(763) 427-9980

Fax(763) 236-8903

Sole ProprietorNo

Medical School CMSOtherGraduated 2026

Enumeration DateJuly 17, 2026

Last NPPES UpdateAugust 12, 20262 updates tracked since enumeration

NPPES CertifiedAugust 12, 2026

✔ NPI 1174443261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MN · 14503

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 2514023 (MN)

4040 COON RAPIDS BLVD NW STE 120, Coon Rapids, MN 55433

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Other Names 1

Former Name (1)Samantha Marie Pitts

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Marie Gudgeon Nurse Practitioner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7810455664

PECOS Enrollment IDI20260821001396

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 Samantha Gudgeon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Allina Health System

Same address

Cardiovascular Disease

4040 COON RAPIDS BLVD NW STE 120
Coon Rapids, MN 55433

Reassigned Medicare billing, Minnesota enrollment
3,733 clinicians in this Medicare group

NPI 1366639460 (763) 427-9980

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 55433 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 20

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

MRS. ASHLEE ANN TAYLOR PA-C

Physician Assistant