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MS. SAMANTHA HERSRUD MD
NPI 1518311679
Internal Medicine in Boise, ID

Active since April 14, 2016PECOS Enrolled
500 W FORT ST, #111, BOISE, ID 83702(208) 422-1000 Get Directions Write a Review

NPPES record last updated: February 17, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Feb 17, 2022, Jun 21, 2019 (2 updates tracked since 2019).

About Ms. Samantha Hersrud Md NPPES

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

MS. SAMANTHA HERSRUD MD (NPI 1518311679) is an individual internal medicine provider in Boise, Idaho, licensed in Idaho (M-14738) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1518311679
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameMS. SAMANTHA HERSRUDCredential: MD
Location Address500 W FORT ST, #111Boise, ID 83702
Mailing Address500 W Fort St 111r, Internal Medicine ResidencyBoise, ID 83702 · (208) 422-1000
Phone(208) 422-1000
Sole ProprietorNo
Enumeration DateApril 14, 2016
Last NPPES UpdateFebruary 17, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 17, 2022
✔ NPI 1518311679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in ID · M-14738
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
500 W FORT ST, Boise, ID 83702
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Samantha Hersrud Md 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 83702 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
$121.27 typical visit price
range $52.44 – $160.17
Typical copayment $30.31 (range $13.11 – $40.04)
Most-billed visit code 99204
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
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 20

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

JESSICA ANN BERNOTSKI RDH
Dental Hygienist
500 W FORT ST
BOISE, ID 83702
Ada County (208) 422-1000
ROBERT FISHER
Registered Nurse (Gastroenterology)
500 W FORT ST
BOISE, ID 83702
Ada County (208) 422-1092
LUKE DANIEL HANSEN MD
Psychiatry & Neurology (Psychiatry)
500 W FORT ST
BOISE, ID 83702
Ada County (208) 422-1000
CHRISTOPHER M GUTIERREZ
Registered Nurse (Gastroenterology)
500 W FORT ST
BOISE, ID 83702
Ada County (208) 422-1000
DR. MICHAEL GLOVER M.D.
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
500 W FORT ST, MAIL CODE #112
BOISE, ID 83702
Ada County (208) 422-1000
DR. ANN DECKER TROTTER PHD
Psychologist (Clinical)
500 W FORT ST
BOISE, ID 83702
Ada County (208) 422-1000
REBECCA COTTERELL RN-BC, BSN
Registered Nurse
500 W FORT ST
BOISE, ID 83702
Ada County (208) 422-1000
PHILIP RESIN ELACKATT RN
Registered Nurse (Pain Management)
500 W FORT ST
BOISE, ID 83702
Ada County (986) 256-1766

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 Hersrud's NPI number?

The NPI number for Samantha Hersrud is 1518311679. It was assigned to this individual provider in the NPPES registry on April 14, 2016.

Where is Samantha Hersrud located?

Samantha Hersrud practices at 500 W Fort St #111, Boise, ID 83702. The listed phone number is (208) 422-1000.

What is Samantha Hersrud's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Samantha Hersrud enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Samantha Hersrud was last updated on February 17, 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.