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SAMANTHA SANDUSKY APRN
NPI 1215467105
Nurse Practitioner in Dayton, OH

Active since June 14, 2017PECOS EnrolledAccepts Medicare Assignment
76.79/100
CMS Quality Rating
1 WYOMING ST, DAYTON, OH 45409(937) 208-8000 Get Directions Write a Review

NPPES record last updated: May 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 15, 2023, Mar 1, 2023, Aug 21, 2020 and 1 more (4 updates tracked since 2017).

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

NPI1215467105
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameSAMANTHA SANDUSKYCredential: APRN
Location Address1 WYOMING STDayton, OH 45409-2722
Mailing Address1 Wyoming StDayton, OH 45409-2722 · (937) 208-8000
Phone(937) 208-8000
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateJune 14, 2017
Last NPPES UpdateMay 15, 20234 updates tracked since enumeration
NPPES CertifiedMay 15, 2023
✔ NPI 1215467105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in OH · APRN.CNP.021301
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.
1 WYOMING ST, Dayton, OH 45409
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual.Insurance ›

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

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.

PECOS PAC ID3971878653
PECOS Enrollment IDI20171005001497
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.

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, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360051
LocationOne Wyoming StreetDayton, OH 45409 · Montgomery County
Emergency services Birthing friendly

Physician 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.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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.

76.79/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.65
Promoting Interoperability100
Improvement Activities40
Cost57.98

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$18.99 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier14 claims14 services$100.72 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

DANIEL NGUYEN
Student in an Organized Health Care Education/Training Program
1 WYOMING ST
DAYTON, OH 45409
Montgomery County (937) 208-3882
KATHY WAYMIRE CRNA
Nurse Anesthetist, Certified Registered
1 WYOMING ST
DAYTON, OH 45409
Montgomery County (800) 394-4445
DR. RORY JON PEPPARD M.D.
Pediatrics (Neonatal-Perinatal Medicine)
1 WYOMING ST, NEONATOLOGY OFFICE
DAYTON, OH 45409
Montgomery County (937) 208-2907
DR. DANIEL PHILLIP PITSTICK D.O.
Emergency Medicine
1 WYOMING ST
DAYTON, OH 45409
Montgomery County (937) 208-3356
DR. WILLIAM R. MARRIOTT M.D.
Emergency Medicine
1 WYOMING ST
DAYTON, OH 45409
Montgomery County (513) 281-4400
MIAMI VALLEY HOSPITAL
Psychiatric Unit
1 WYOMING ST
DAYTON, OH 45409
Montgomery County (937) 208-8000
LEILA CONSTANCE TOU
Student in an Organized Health Care Education/Training Program
1 WYOMING ST
DAYTON, OH 45409
Montgomery County (937) 208-2866
DR. JARED COTTINGIM RPH
Pharmacist
1 WYOMING ST
DAYTON, OH 45409
Montgomery County (937) 208-3195

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.

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.