SAMANTHA SANDUSKY APRN
NPI 1215467105
Nurse Practitioner in Dayton, OH
About Samantha Sandusky Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMANTHA SANDUSKY APRN (NPI 1215467105) is an individual nurse practitioner in Dayton, Ohio, licensed in Ohio (APRN.CNP.021301) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS, is affiliated with Miami Valley Hospital, and is a graduate of Other (2017).
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 Sandusky Aprn 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 Sandusky reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Dayton, OH 45409
- Reassigned Medicare billing, Ohio enrollment
- 812 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.
Miami Valley Hospital
Acute Care Hospitals · Dayton, OHPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 45409 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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.
DAYTON, OH 45409
DAYTON, OH 45409
DAYTON, OH 45409
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 Sandusky's NPI number?
The NPI number for Samantha Sandusky is 1215467105. It was assigned to this individual provider in the NPPES registry on June 14, 2017.
Where is Samantha Sandusky located?
Samantha Sandusky practices at 1 Wyoming St, Dayton, OH 45409. The listed phone number is (937) 208-8000.
What is Samantha Sandusky's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Samantha Sandusky enrolled in Medicare?
Yes. Samantha Sandusky 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 Sandusky's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Sandusky reassigns Medicare benefits to Premier Health Specialists Inc (Dayton, OH). 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 Sandusky's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Samantha Sandusky accept?
Health plans from Anthem Blue Cross and Blue Shield, CareSource and MedMutual list Samantha Sandusky 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 Sandusky affiliated with any hospitals?
According to CMS data, Samantha Sandusky is affiliated with Miami Valley Hospital.
When was this NPI record last updated?
The NPPES record for Samantha Sandusky was last updated on May 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Samantha Sandusky, APRN · NPI 1215467105
Nurse Practitioner physician in Dayton, Ohio. Individual provider, active in the CMS NPPES registry since June 14, 2017.
## Identity
- **NPI:** 1215467105 (Entity type: Individual)
- **Enumerated:** June 14, 2017
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** APRN.CNP.021301 (Ohio)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1 WYOMING ST, Dayton, OH 45409-2722
- **Phone:** (937) 208-8000
## 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:** Premier Health Specialists Inc (NPI 1114213055, Dayton, OH), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** May 15, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1215467105) · Data from the CMS NPPES public registry.