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SAMANTHA ANN OLSENEVICH PA-C
NPI 1407474430
Physician Assistant - Medical in Farmington, CT

Active since July 07, 2020PECOS EnrolledAccepts Medicare Assignment
73.56/100
CMS Quality Rating
263 FARMINGTON AVE, FARMINGTON, CT 06030(860) 679-2792(860) 679-1494 Get Directions Write a Review

NPPES record last updated: February 6, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 6, 2026, Jan 3, 2024, Feb 15, 2022 and 2 more (5 updates tracked since 2020).

About Samantha Ann Olsenevich Pa-c NPPES

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

SAMANTHA ANN OLSENEVICH PA-C (NPI 1407474430) is an individual medical provider in Farmington, Connecticut, licensed in Connecticut (4829) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1407474430
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameSAMANTHA ANN OLSENEVICHCredential: PA-C
Location Address263 FARMINGTON AVEFarmington, CT 06030-8085
Mailing Address263 Farmington AveFarmington, CT 06030-8082 · (860) 679-2792 · Fax (860) 679-1494
Phone(860) 679-2792
Fax(860) 679-1494
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJuly 7, 2020
Last NPPES UpdateFebruary 6, 20265 updates tracked since enumeration
NPPES CertifiedFebruary 6, 2026
✔ NPI 1407474430 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CT · 4829
Also ListedPhysician AssistantTaxonomy 363A00000X
263 FARMINGTON AVE, Farmington, CT 06030
Open in Google Maps ↗

Other Names 1

Former Name (1)Samantha Ann Couillard

Secondary Practice Locations 2

Location 185 Seymour StHartford, CT 06106-5501 · Phone (608) 972-4183
Location 26 Devine StNorth Haven, CT 06473-2195 · Phone (203) 200-4422

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 Ann Olsenevich Pa-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 ID2668882770
PECOS Enrollment IDI20201030001686
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 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.

73.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.84
Promoting Interoperability74
Improvement Activities40
Cost51.43

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Parenteral nutrition solution, not otherwise specified, 10 grams lipids B4185
Other-Enteral and Parenteral · category OB005N
2 suppliers15 claims232 services$10.26 avg. paid by Medicare
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix B4197
Other-Enteral and Parenteral · category OB005N
2 suppliers15 claims68 services$278.65 avg. paid by Medicare
Parenteral nutrition supply kit; premix, per day B4220
Other-Enteral and Parenteral · category OB005N
2 suppliers24 claims104 services$8.00 avg. paid by Medicare
Parenteral nutrition administration kit, per day B4224
Other-Enteral and Parenteral · category OB005N
2 suppliers23 claims100 services$24.96 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.

STATE OF CONNECTICUT HEALTH CENTER
Pathology (Anatomic Pathology & Clinical Pathology)
263 FARMINGTON AVE, LABORATORY HBP GROUP
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-7503
MR. IAN THOMAS MCNEILL
Neurological Surgery
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-8080
DR. LUIS CHAVEZ DE PAZ DDS, MS, PHD
Dentist (Endodontics)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-2719
TARUNYA REDDY VEDERE
Internal Medicine (Endocrinology, Diabetes & Metabolism)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3245
ZACHARY TALLENT SOLOMON
Surgery
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3467
MICHAEL CONNOLLY
Psychiatry & Neurology (Psychiatry)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-4733
EMILY WENG DO
Internal Medicine (Gastroenterology)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3158
ANDREW KEMERLEY DO
Student in an Organized Health Care Education/Training Program
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3467

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 Olsenevich's NPI number?

The NPI number for Samantha Olsenevich is 1407474430. It was assigned to this individual provider in the NPPES registry on July 7, 2020. The provider is also known as Samantha Ann Couillard.

Where is Samantha Olsenevich located?

Samantha Olsenevich practices at 263 Farmington Ave, Farmington, CT 06030. The listed phone number is (860) 679-2792.

What is Samantha Olsenevich's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Samantha Olsenevich enrolled in Medicare?

Yes. Samantha Olsenevich 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 Samantha Olsenevich was last updated on February 6, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.