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DR. SAMUEL A MORTENSEN D.M.D
NPI 1427240282
Dentist - General Practice in Phoenix, AZ

Active since August 15, 2007PECOS Enrolled
4212 N 16TH ST, PHOENIX, AZ 85016(602) 263-1200(602) 200-5383 Get Directions Write a Review

NPPES record last updated: July 29, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Samuel A Mortensen D.m.d NPPES

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

DR. SAMUEL A MORTENSEN D.M.D (NPI 1427240282) is an individual general practice provider in Phoenix, Arizona, licensed in Arizona (7351) and active in the NPI registry since August 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1427240282
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. SAMUEL A MORTENSENCredential: D.M.D
Location Address4212 N 16TH STPhoenix, AZ 85016-5319
Mailing Address4212 N 16th StPhoenix, AZ 85016-5319 · (602) 263-1200 · Fax (602) 200-5383
Phone(602) 263-1200
Fax(602) 200-5383
Sole ProprietorNo
Enumeration DateAugust 15, 2007
Last NPPES UpdateJuly 29, 2015
✔ NPI 1427240282 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in AZ · 7351✔ Licensed in CO · DEN.00201822
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
4212 N 16TH ST, Phoenix, AZ 85016
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Samuel A Mortensen D.m.d 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85016 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
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 20

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

WENDY RAZO
Registered Nurse (Obstetric, High-Risk)
4212 N 16TH ST
PHOENIX, AZ 85016
Maricopa County (602) 263-1200
THOMAS RYAN HALL RN
Registered Nurse
4212 N 16TH ST
PHOENIX, AZ 85016
Maricopa County (602) 263-1200
DR. UMAR IQBAL M.D.
Family Medicine
4212 N 16TH ST
PHOENIX, AZ 85016
Maricopa County (602) 263-1200
SHARLA LOUISE WYATT RN
Registered Nurse
4212 N 16TH ST
PHOENIX, AZ 85016
Maricopa County (602) 263-1200
KATELYN WENTWORTH PELTIER PHARMD
Pharmacist
4212 N 16TH ST
PHOENIX, AZ 85016
Maricopa County (602) 263-1200
LAURA MOLANDER
Pharmacist
4212 N 16TH ST
PHOENIX, AZ 85016
Maricopa County (602) 263-1200
DR. ADEL M SALAMA M.D.
Internal Medicine
4212 N 16TH ST
PHOENIX, AZ 85016
Maricopa County (602) 263-1200
ANCITA BIGMAN RN
Registered Nurse
4212 N 16TH ST
PHOENIX, AZ 85016
Maricopa County (602) 263-1511

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 Samuel Mortensen's NPI number?

The NPI number for Samuel Mortensen is 1427240282. It was assigned to this individual provider in the NPPES registry on August 15, 2007.

Where is Samuel Mortensen located?

Samuel Mortensen practices at 4212 N 16th St, Phoenix, AZ 85016. The listed phone number is (602) 263-1200.

What is Samuel Mortensen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Samuel Mortensen enrolled in Medicare?

Yes. Samuel Mortensen is registered in the Medicare PECOS enrollment system.

What insurance does Samuel Mortensen accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Samuel Mortensen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samuel Mortensen was last updated on July 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.