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SAMANTHA MARIE HLEBAK DO
NPI 1366182818
Student in an Organized Health Care Education/Training Program in Peoria, IL

Active since March 31, 2022PECOS Enrolled
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-7171 Get Directions Write a Review

NPPES record last updated: March 31, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Samantha Marie Hlebak Do NPPES

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

SAMANTHA MARIE HLEBAK DO (NPI 1366182818) is an individual student in an organized health care education/training program in Peoria, Illinois and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366182818
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSAMANTHA MARIE HLEBAKCredential: DO
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address7432 Quail Meadow LnCharlotte, NC 28210-5127 · (704) 942-8065
Phone(309) 655-7171
Sole ProprietorNo
Enumeration DateMarch 31, 2022
NPPES CertifiedMarch 31, 2022
✔ NPI 1366182818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
530 NE GLEN OAK AVE, Peoria, IL 61637
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Marie Hlebak Do 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.

Medicare Billing Reassignment

Medicare enrollment records show Samantha Hlebak reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Carolinas Medical Center
601 mi
Psychiatry
16740 DAVIDSON CONCORD RD, STE 200
Davidson, NC 28036
  • Reassigned Medicare billing, North Carolina enrollment
  • 2,223 clinicians in this Medicare group
NPI 1629412184 (704) 801-9200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

DR. HAMID MAHMOOD ZIA M.D
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Peoria County (309) 624-9011
THOMAS JAMES MCMORROW MD
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109
ABIGAIL V. WELU DO
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-6710
DR. JAMES DANIEL DEWAR D.O.
Internal Medicine (Interventional Cardiology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-7257

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 Hlebak's NPI number?

The NPI number for Samantha Hlebak is 1366182818. It was assigned to this individual provider in the NPPES registry on March 31, 2022.

Where is Samantha Hlebak located?

Samantha Hlebak practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 655-7171.

What is Samantha Hlebak's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Samantha Hlebak enrolled in Medicare?

Yes. Samantha Hlebak is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Samantha Hlebak's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Hlebak reassigns Medicare benefits to Carolinas Medical Center (Davidson, NC). 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 Hlebak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Samantha Hlebak was last updated on March 31, 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.