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SAMANTHA ZEISLOFT PMHNP-BC
NPI 1417626490
Nurse Practitioner - Psychiatric/Mental Health in Mercer Island, WA

Active since September 13, 2021PECOS Enrolled
9725 SE 36TH ST, MERCER ISLAND, WA 98040(678) 674-4004(773) 824-2303 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 25, 2025, May 12, 2024, Jul 18, 2022 and 2 more (5 updates tracked since 2021).

About Samantha Zeisloft Pmhnp-bc NPPES

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

SAMANTHA ZEISLOFT PMHNP-BC (NPI 1417626490) is an individual psychiatric/mental health provider in Mercer Island, Washington, licensed in Washington (AP61489940) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Riverdale.

NPPES Registry Identity

NPI1417626490
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameSAMANTHA ZEISLOFTCredential: PMHNP-BC
Location Address9725 SE 36TH STMercer Island, WA 98040-3841
Mailing Address120 Heatherwood DrFayetteville, GA 30215-2125 · (770) 654-6835 · Fax (773) 824-2303
Phone(678) 674-4004
Fax(773) 824-2303
Sole ProprietorYes
Enumeration DateSeptember 13, 2021
Last NPPES UpdateApril 22, 20255 updates tracked since enumeration
NPPES CertifiedApril 22, 2025
✔ NPI 1417626490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in WA · AP61489940✔ Licensed in CO · C-APN.0101357-C-NP✔ Licensed in GA · RN285551
9725 SE 36TH ST, Mercer Island, WA 98040
Open in Google Maps ↗

Secondary Practice Location 1

Location 1223 Medical Center DrRiverdale, GA 30274-2640 · Phone (678) 674-4004 · Fax (773) 824-2303

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Zeisloft Pmhnp-bc 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 Zeisloft reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Personal Recovery Network LLC
2,194 mi
Psychiatry
250 CORPORATE CENTER CT
Stockbridge, GA 30281
  • Reassigned Medicare billing, Georgia enrollment
  • 592 clinicians in this Medicare group
NPI 1881990869 (770) 389-8100

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98040 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
$97.43 typical visit price
range $63.67 – $189.37
Typical copayment $24.35 (range $15.91 – $47.34)
Most-billed visit code 99203
Established Patient
$111.00 typical visit price
range $21.12 – $155.00
Typical copayment $27.75 (range $5.28 – $38.75)
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 9

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

ROBIN H FONTANA ARNP
Registered Nurse (Gerontology)
9725 SE 36TH ST, SUITE 214
MERCER ISLAND, WA 98040
King County (206) 275-3588
MR. DAN W REIFF PH.D.
Nutritionist
9725 SE 36TH ST, SUITE 301
MERCER ISLAND, WA 98040
King County (206) 232-8404
SONJA BRADFORD MS, CCC-SLP
Speech-Language Pathologist
9725 SE 36TH ST
MERCER ISLAND, WA 98040
King County (206) 232-2046
DR. MARY ANNE EARLS PH.D.
Psychologist
9725 SE 36TH ST, SUITE 212
MERCER ISLAND, WA 98040
King County (206) 236-5678
DR. KATHLEEN KIM LAMPSON REIFF PH.D.
Psychologist
9725 SE 36TH ST, SUITE 301
MERCER ISLAND, WA 98040
King County (206) 232-8404
LESA BLACK M.S. CCC-SLP
Speech-Language Pathologist
9725 SE 36TH ST, SUITE 205
MERCER ISLAND, WA 98040
King County (206) 232-2046
DR. THUCUC THI-THU NGUYEN M.D.
Psychiatry & Neurology (Psychiatry)
9725 SE 36TH ST, SUITE
MERCER ISLAND, WA 98040
King County (206) 236-5553
DR. MARY PATRICIA BROWNING ND
Naturopath
9725 SE 36TH ST, SUITE 212
MERCER ISLAND, WA 98040
King County (206) 486-4292

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 Zeisloft's NPI number?

The NPI number for Samantha Zeisloft is 1417626490. It was assigned to this individual provider in the NPPES registry on September 13, 2021.

Where is Samantha Zeisloft located?

Samantha Zeisloft practices at 9725 SE 36th St, Mercer Island, WA 98040. The listed phone number is (678) 674-4004.

What is Samantha Zeisloft's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Samantha Zeisloft enrolled in Medicare?

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

Which organization bills Medicare for Samantha Zeisloft's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Zeisloft reassigns Medicare benefits to Personal Recovery Network LLC (Stockbridge, GA). 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 Zeisloft'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 Zeisloft was last updated on April 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.