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KIMBERLY SAMUELSON FNP-C
NPI 1396541124
Nurse Practitioner in Puyallup, WA

Active since February 21, 2025PECOS EnrolledAccepts Medicare Assignment
9909 168TH ST E STE 102, PUYALLUP, WA 98375(253) 445-3000 Get Directions Write a Review

NPPES record last updated: February 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kimberly Samuelson Fnp-c NPPES

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

KIMBERLY SAMUELSON FNP-C (NPI 1396541124) is an individual nurse practitioner in Puyallup, Washington, licensed in Washington (61570680) and active in the NPI registry since February 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1396541124
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKIMBERLY SAMUELSONCredential: FNP-C
Location Address9909 168TH ST E STE 102Puyallup, WA 98375-2513
Mailing Address9909 168th St E Ste 102Puyallup, WA 98375-2513 · (253) 445-3000
Phone(253) 445-3000
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateFebruary 21, 2025
Last NPPES UpdateFebruary 23, 2025
NPPES CertifiedFebruary 23, 2025
✔ NPI 1396541124 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 WA · 61570680
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.
9909 168TH ST E STE 102, Puyallup, WA 98375
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Other Names 1

Former Name (1)Kimberly Huckleby

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

Kimberly Samuelson Fnp-c 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 ID6002399524
PECOS Enrollment IDI20260312003702
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98375 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
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.

Other Providers at the Same Location NPPES 4

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

NORDQUIST INTEGRATED MEDICINE
Integrative Medicine
9909 168TH ST E STE 102
PUYALLUP, WA 98375
Pierce County (253) 445-3000
MRS. HANNAH CHRISTINE THAYER LMP
Massage Therapist
9909 168TH ST E STE 102
PUYALLUP, WA 98375
Pierce County (253) 445-3000
AMY LOUISE CLEVELAND
Massage Therapist
9909 168TH ST E STE 102
PUYALLUP, WA 98375
Pierce County (253) 445-3000
DURABLE MEDICAL EQUIPMENT LLC
Durable Medical Equipment & Medical Supplies
9909 168TH ST E STE 102
PUYALLUP, WA 98375
Pierce County (253) 961-6880

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 Kimberly Samuelson's NPI number?

The NPI number for Kimberly Samuelson is 1396541124. It was assigned to this individual provider in the NPPES registry on February 21, 2025. The provider is also known as Kimberly Huckleby.

Where is Kimberly Samuelson located?

Kimberly Samuelson practices at 9909 168th St E Ste 102, Puyallup, WA 98375. The listed phone number is (253) 445-3000.

What is Kimberly Samuelson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kimberly Samuelson enrolled in Medicare?

Yes. Kimberly Samuelson 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.

When was this NPI record last updated?

The NPPES record for Kimberly Samuelson was last updated on February 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.