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NATALIA SAMUDOVSKY LCPC
NPI 1649752403
Counselor - Professional in Boise, ID

Active since August 29, 2018PECOS Enrolled
12553 W EXPLORER DR STE 190, BOISE, ID 83713(208) 376-7083(208) 321-5069 Get Directions Write a Review

NPPES record last updated: August 1, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Natalia Samudovsky Lcpc NPPES

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

NATALIA SAMUDOVSKY LCPC (NPI 1649752403) is an individual professional provider in Boise, Idaho, licensed in Idaho (9023) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1649752403
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameNATALIA SAMUDOVSKYCredential: LCPC
Location Address12553 W EXPLORER DR STE 190Boise, ID 83713-1612
Mailing Address12553 W Explorer Dr Ste 190Boise, ID 83713-1612 · (208) 376-7083 · Fax (208) 321-5069
Phone(208) 376-7083
Fax(208) 321-5069
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateAugust 29, 2018
Last NPPES UpdateAugust 1, 2023
NPPES CertifiedAugust 1, 2023
✔ NPI 1649752403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in ID · 9023
Also ListedCounselorTaxonomy 101Y00000X · License 6969 (ID)
12553 W EXPLORER DR STE 190, Boise, ID 83713
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, PacificSource Health Plans, Select Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Natalia Samudovsky Lcpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4284129594
PECOS Enrollment IDI20251223003198
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 Natalia Samudovsky reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St Lukes Clinic-Treasure Valley LLC
8.1 mi
Family Medicine
190 E BANNOCK ST
Boise, ID 83712
  • Reassigned Medicare billing, Idaho enrollment
  • 1,312 clinicians in this Medicare group
NPI 1326336058 (208) 381-2222

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

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.

AMBER LAROCCO CADC
Peer Specialist
12553 W EXPLORER DR STE 190
BOISE, ID 83713
Ada County (208) 376-7083
CADEN SEAN BENZINGER LPC
Counselor (Professional)
12553 W EXPLORER DR STE 190
BOISE, ID 83713
Ada County (208) 376-7083
SARAH E SAMSON LCSW
Counselor (Addiction (Substance Use Disorder))
12553 W EXPLORER DR STE 190
BOISE, ID 83713
Ada County (208) 376-7083
MENTOR IDAHO, LLC
Clinic/Center (Developmental Disabilities)
12553 W EXPLORER DR STE 190
BOISE, ID 83713
Ada County (951) 201-5914
MONICA VIRGEN
Behavior Technician
12553 W EXPLORER DR STE 190
BOISE, ID 83713
Ada County (208) 972-5254
TRIVIUM LIFE SERVICES MOUNTAIN WEST, LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
12553 W EXPLORER DR STE 190
BOISE, ID 83713
Ada County (208) 376-7083
DARBY ALISON OTTINGER
Behavior Technician
12553 W EXPLORER DR STE 190
BOISE, ID 83713
Ada County (208) 972-5254
NICOLE LAINE MARTINEZ
Behavior Technician
12553 W EXPLORER DR STE 190
BOISE, ID 83713
Ada County (208) 972-5254

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 Natalia Samudovsky's NPI number?

The NPI number for Natalia Samudovsky is 1649752403. It was assigned to this individual provider in the NPPES registry on August 29, 2018.

Where is Natalia Samudovsky located?

Natalia Samudovsky practices at 12553 W Explorer Dr Ste 190, Boise, ID 83713. The listed phone number is (208) 376-7083.

What is Natalia Samudovsky's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Natalia Samudovsky enrolled in Medicare?

Yes. Natalia Samudovsky is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Natalia Samudovsky's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Natalia Samudovsky reassigns Medicare benefits to St Lukes Clinic-Treasure Valley LLC (Boise, ID). 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 Natalia Samudovsky's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Natalia Samudovsky accept?

Health plans from Molina Healthcare, PacificSource Health Plans and Select Health list Natalia Samudovsky 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 Natalia Samudovsky was last updated on August 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.