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DR. SAMANTHA JIMENEZ PSY.D.
NPI 1619302072
Psychologist - Clinical in Bellevue, WA

Active since September 04, 2013PECOS Enrolled
13451 SE 36TH ST, BELLEVUE, WA 98006(425) 562-1337 Get Directions Write a Review

NPPES record last updated: May 17, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Samantha Jimenez Psy.d. NPPES

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

DR. SAMANTHA JIMENEZ PSY.D. (NPI 1619302072) is an individual clinical provider in Bellevue, Washington, licensed in Washington (PY60480722) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619302072
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. SAMANTHA JIMENEZCredential: PSY.D.
Location Address13451 SE 36TH STBellevue, WA 98006-1475
Mailing Address13451 Se 36th StBellevue, WA 98006-1475 · (425) 562-1337
Phone(425) 562-1337
Sole ProprietorNo
Enumeration DateSeptember 4, 2013
Last NPPES UpdateMay 17, 2021
NPPES CertifiedMay 17, 2021
✔ NPI 1619302072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in WA · PY60480722
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License MC60269765 (WA)
13451 SE 36TH ST, Bellevue, WA 98006
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Samantha Jimenez Psy.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.

Medicare Billing Reassignment

Medicare enrollment records show Samantha Jimenez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kaiser Foundation Health Plan Of Washington
8.8 mi
Multi-Specialty
320 WESTLAKE AVE. N., SUITE 100
Seattle, WA 98109
  • Reassigned Medicare billing, Washington enrollment
  • 2,678 clinicians in this Medicare group
NPI 1396810701 (206) 448-6561

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 98006 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
$189.37 typical visit price
range $63.67 – $189.37
Typical copayment $47.34 (range $15.91 – $47.34)
Most-billed visit code 99205
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 20

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

MRS. OLGA GODINA M.D.
Psychiatry & Neurology (Psychiatry)
13451 SE 36TH ST
BELLEVUE, WA 98006
King County (425) 562-1337
TED W FARRAND
Psychiatry & Neurology (Psychiatry)
13451 SE 36TH ST
BELLEVUE, WA 98006
King County (425) 562-1337
SUSAN E LASICKA
Pharmacist
13451 SE 36TH ST
BELLEVUE, WA 98006
King County (425) 562-1337
JYOTI BENJAMIN MD,RD, CD
Dietitian, Registered
13451 SE 36TH ST
BELLEVUE, WA 98006
King County (425) 562-1337
DR. ASHOK SHIMOJI-KRISHNAN MD, MPH
Psychiatry & Neurology (Child & Adolescent Psychiatry)
13451 SE 36TH ST
BELLEVUE, WA 98006
King County (425) 562-1337
DR. JEFF L VANNICE PHD
Psychologist (Clinical)
13451 SE 36TH ST
BELLEVUE, WA 98006
King County (425) 562-1337
MAMATHA PALANATI
Family Medicine
13451 SE 36TH ST
BELLEVUE, WA 98006
King County (425) 562-1337
CHERYL POYNOR LICSW
Social Worker (Clinical)
13451 SE 36TH ST
BELLEVUE, WA 98006
King County (425) 562-1337

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 Jimenez's NPI number?

The NPI number for Samantha Jimenez is 1619302072. It was assigned to this individual provider in the NPPES registry on September 4, 2013.

Where is Samantha Jimenez located?

Samantha Jimenez practices at 13451 SE 36th St, Bellevue, WA 98006. The listed phone number is (425) 562-1337.

What is Samantha Jimenez's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Samantha Jimenez enrolled in Medicare?

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

Which organization bills Medicare for Samantha Jimenez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Jimenez reassigns Medicare benefits to Kaiser Foundation Health Plan Of Washington (Seattle, WA). 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 Jimenez'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 Jimenez was last updated on May 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.