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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.

DR. SCOTT GUSTAV SAMELSON M.D.
NPI 1356583264
Family Medicine in Tahoe City, CA

Active since March 24, 2009PECOS Enrolled
925 NORTH LAKE BLVD, TAHOE CITY, CA 96145(530) 581-8864 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Scott Gustav Samelson M.d. NPPES

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

DR. SCOTT GUSTAV SAMELSON M.D. (NPI 1356583264) is an individual family medicine provider in Tahoe City, California, licensed in California (A126885) and active in the NPI registry since March 2009. He is enrolled in Medicare PECOS, is affiliated with Incline Village Community Hospital, and is a graduate of University Of Colorado School Of Medicine, Denver (2009).

NPPES Registry Identity

NPI1356583264
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SCOTT GUSTAV SAMELSONCredential: M.D.
Location Address925 NORTH LAKE BLVDTahoe City, CA 96145
Mailing Address3190 Fabian WayTahoe City, CA 96145-2032 · (530) 386-1701
Phone(530) 581-8864
Sole ProprietorNo
Medical School CMSUniversity Of Colorado School Of Medicine, DenverGraduated 2009
Enumeration DateMarch 24, 2009
Last NPPES UpdateJuly 29, 2026
NPPES CertifiedJuly 29, 2026
✔ NPI 1356583264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A126885
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
925 NORTH LAKE BLVD, Tahoe City, CA 96145
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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 and accepts Medicare assignment

Dr. Scott Gustav Samelson M.d. 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 ID5193954311
PECOS Enrollment IDI20140211001862, I20210622000402
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.

Areas of Expertise CMS Part B claims 9

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
179 services133 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
66 services66 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
65 services64 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
62 services62 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
40 services40 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
38 services30 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Incline Village Community Hospital

Critical Access Hospitals · Incline Village, NV
OwnershipGovernment - Hospital District or Authority
CMS Certification Number291301
Location880 Alder StreetIncline Village, NV 89451 · Washoe County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96145 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
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.

Referred Medical Equipment & Supplies CMS DME claims 3

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
2 suppliers23 claims23 services$16.34 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
3 suppliers35 claims35 services$78.12 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$32.91 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 2

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

DR. ROBERT EDWARD CLAMAN D.D.S.
Dentist (General Practice)
925 NORTH LAKE BLVD, SUITE B-206
TAHOE CITY, CA 96145
Placer County (530) 583-4276
KATY SCHOUSEN MD
Family Medicine
925 NORTH LAKE BLVD
TAHOE CITY, CA 96145
Placer County (530) 581-8864

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 Scott Samelson's NPI number?

The NPI number for Scott Samelson is 1356583264. It was assigned to this individual provider in the NPPES registry on March 24, 2009.

Where is Scott Samelson located?

Scott Samelson practices at 925 North Lake Blvd, Tahoe City, CA 96145. The listed phone number is (530) 581-8864.

What is Scott Samelson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Scott Samelson enrolled in Medicare?

Yes. Scott Samelson 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.

Is Scott Samelson affiliated with any hospitals?

According to CMS data, Scott Samelson is affiliated with Incline Village Community Hospital.

When was this NPI record last updated?

The NPPES record for Scott Samelson was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.