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MISS SAMANTHA ELIZABETH POLIKOWSKI R.N.
NPI 1194134114
Nurse Anesthetist, Certified Registered in Boston, MA

Active since August 04, 2014Accepts Medicare Assignment

NPPES record last updated: March 16, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 11, 2022, Jan 31, 2022 (2 updates tracked since 2022).

About Miss Samantha Elizabeth Polikowski R.n. NPPES

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

MISS SAMANTHA ELIZABETH POLIKOWSKI R.N. (NPI 1194134114) is an individual nurse anesthetist, certified registered in Boston, Massachusetts, licensed in California (95001608) and active in the NPI registry since August 2014. She maintains 2 additional practice locations and is a graduate of Other (2016).

NPPES Registry Identity

NPI1194134114
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameMISS SAMANTHA ELIZABETH POLIKOWSKICredential: R.N.
Location Address55 FRUIT STBoston, MA 02114-2621
Mailing AddressPo Box 232410San Diego, CA 92193-2410
Phone(617) 724-4910
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 4, 2014
Last NPPES UpdateMarch 16, 20222 updates tracked since enumeration
NPPES CertifiedMarch 16, 2022
✔ NPI 1194134114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in CA · 95001608
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Also ListedRegistered Nurse · Critical Care MedicineTaxonomy 163WC0200X · License 2267172 (MA)
55 FRUIT ST, Boston, MA 02114
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1200 W Arbor DrSan Diego, CA 92103-9000 · Phone (800) 926-8273
Location 2995 Gateway Center Way Ste 207San Diego, CA 92102-4544 · Phone (619) 263-9729 · Fax (619) 263-9730

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Miss Samantha Elizabeth Polikowski R.n. 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 ID6204122435
PECOS Enrollment IDI20211109001739

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.

Anesthesia for lens surgery 00142
Anesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.
28 services28 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 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
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
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 20

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

STUTI GIRISH SHROFF MD, MBBS
Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2971
NANCY WANG M.D.
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (017) 724-4000
DR. DUSAN HANIDZIAR M.D., PH.D.
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Suffolk County (617) 726-3030
JOHN JOSEPH DANKO DO
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2000
DR. MICHAEL ANDREW LOBRITZ M.D, PH.D.
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Suffolk County (617) 724-9248
MS. KELLY ELISHA TRECARTIN NP
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Suffolk County (617) 726-7400
JAMIE MARIE ALLEN NP
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 724-4410
DR. DHAVAL SANJEEV KOLTE M.B.B.S., PH.D.
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 643-3238

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 Polikowski's NPI number?

The NPI number for Samantha Polikowski is 1194134114. It was assigned to this individual provider in the NPPES registry on August 4, 2014.

Where is Samantha Polikowski located?

Samantha Polikowski practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 724-4910.

What is Samantha Polikowski's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Samantha Polikowski enrolled in Medicare?

Yes. Samantha Polikowski 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.

When was this NPI record last updated?

The NPPES record for Samantha Polikowski was last updated on March 16, 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.