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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SAMUEL BLOOMSBURG
NPI 1194394502
Surgery in Morris, MN

Active since June 21, 2021PECOS Enrolled
400 E 1ST ST, MORRIS, MN 56267(320) 589-1313(320) 589-1065 Get Directions Write a Review

NPPES record last updated: July 30, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 30, 2026, Jun 21, 2021 (2 updates tracked since 2021).

About Samuel Bloomsburg NPPES

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

SAMUEL BLOOMSBURG (NPI 1194394502) is an individual surgery provider in Morris, Minnesota, licensed in North Dakota (RL17467) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194394502
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameSAMUEL BLOOMSBURG
Location Address400 E 1ST STMorris, MN 56267-1408
Mailing Address400 E 1st StMorris, MN 56267-1408 · (320) 589-1313 · Fax (320) 589-1065
Phone(320) 589-1313
Fax(320) 589-1065
Sole ProprietorYes
Enumeration DateJune 21, 2021
Last NPPES UpdateJuly 30, 20262 updates tracked since enumeration
NPPES CertifiedJuly 30, 2026
✔ NPI 1194394502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in ND · RL17467
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
400 E 1ST ST, Morris, MN 56267
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Bloomsburg 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56267 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
$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 20

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

JOHN SOONTOHRN ANDERSON DO
Family Medicine
400 E 1ST ST
MORRIS, MN 56267
Stevens County (320) 589-1313
SANFORD MEDICAL CENTER FARGO
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
400 E 1ST ST
MORRIS, MN 56267
Stevens County (320) 589-2832
STEPHANIE JOY KNOBLOCH CFNP
Nurse Practitioner (Family)
400 E 1ST ST
MORRIS, MN 56267
Stevens County (320) 589-1313
MR. STEVEN EDWARD LIENEMANN RPH
Pharmacist
400 E 1ST ST
MORRIS, MN 56267
Stevens County (320) 589-7679
DR. DANIEL JAMES O'CONNOR MD
Family Medicine
400 E 1ST ST
MORRIS, MN 56267
Stevens County (320) 589-1313
TIERZA THORMODSON
Nurse Practitioner (Family)
400 E 1ST ST
MORRIS, MN 56267
Stevens County (320) 589-1313
RISA ANN DORWEILER NP
Nurse Practitioner
400 E 1ST ST
MORRIS, MN 56267
Stevens County (320) 589-1313
BENJAMIN BERDAL DPT
Physical Therapist
400 E 1ST ST
MORRIS, MN 56267
Stevens County (320) 589-7658

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 Samuel Bloomsburg's NPI number?

The NPI number for Samuel Bloomsburg is 1194394502. It was assigned to this individual provider in the NPPES registry on June 21, 2021.

Where is Samuel Bloomsburg located?

Samuel Bloomsburg practices at 400 E 1st St, Morris, MN 56267. The listed phone number is (320) 589-1313.

What is Samuel Bloomsburg's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Samuel Bloomsburg enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Samuel Bloomsburg was last updated on July 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days 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.