SAMANTHA L THIEDE APNP
NPI 1306454053
Nurse Practitioner in Waupun, WI
About Samantha L Thiede Apnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMANTHA L THIEDE APNP (NPI 1306454053) is an individual nurse practitioner in Waupun, Wisconsin, licensed in Wisconsin (10152) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS, is affiliated with St. Agnes Hospital Hospice, and maintains a secondary practice location in Appleton.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
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 L Thiede Apnp 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 Thiede reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Beaver Dam, WI 53916
- Reassigned Medicare billing, Wisconsin enrollment
- 606 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.
Areas of Expertise CMS Part B claims 5
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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St. Agnes Hospital Hospice
Acute Care Hospitals · Fond Du Lac, WIWaupun Memorial Hospital
Critical Access Hospitals · Waupun, WIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 53963 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Thiede's NPI number?
The NPI number for Samantha Thiede is 1306454053. It was assigned to this individual provider in the NPPES registry on July 20, 2020.
Where is Samantha Thiede located?
Samantha Thiede practices at 608 W Brown St, Waupun, WI 53963. The listed phone number is (920) 324-6801.
What is Samantha Thiede's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Samantha Thiede enrolled in Medicare?
Yes. Samantha Thiede 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 Thiede's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Thiede reassigns Medicare benefits to Agnesian Healthcare (Beaver Dam, WI). 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 Thiede's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Samantha Thiede accept?
Health plans from Anthem Blue Cross and Blue Shield and Network Health list Samantha Thiede 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 Thiede affiliated with any hospitals?
According to CMS data, Samantha Thiede is affiliated with St. Agnes Hospital Hospice and Waupun Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Samantha Thiede was last updated on May 4, 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.
# Samantha L Thiede, APNP · NPI 1306454053
Nurse Practitioner physician in Waupun, Wisconsin. Individual provider, active in the CMS NPPES registry since July 20, 2020.
## Identity
- **NPI:** 1306454053 (Entity type: Individual)
- **Enumerated:** July 20, 2020
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 10152 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 608 W BROWN ST, Waupun, WI 53963-1788
- **Phone:** (920) 324-6801
## 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:** Agnesian Healthcare (NPI 1700817657, Beaver Dam, WI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** May 4, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1306454053) · Data from the CMS NPPES public registry.