SAMANTHA LYNNE FREDRICKSON FNP
NPI 1659008670
Nurse Practitioner - Family in Fort Wayne, IN

Q: What is Samantha Fredrickson's NPI number?

The NPI number for Samantha Fredrickson is 1659008670. It was assigned to this individual provider in the NPPES registry on August 1, 2022.

Q: What is Samantha Fredrickson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since August 01, 2022PECOS Enrolled

2100 GOSHEN RD, FORT WAYNE, IN 46808(260) 471-3500 Get Directions Write a Review

NPPES record last updated: August 1, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Samantha Lynne Fredrickson Fnp NPPES

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

SAMANTHA LYNNE FREDRICKSON FNP (NPI 1659008670) is an individual family provider in Fort Wayne, Indiana, licensed in Indiana (71012743A) and active in the NPI registry since August 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1659008670

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSAMANTHA LYNNE FREDRICKSONCredential: FNP

Location Address2100 GOSHEN RDFort Wayne, IN 46808-1493

Mailing Address1211 Almdale DrFort Wayne, IN 46818-8429 · (260) 358-7721

Phone(260) 471-3500

Sole ProprietorNo

Enumeration DateAugust 1, 2022

NPPES CertifiedAugust 1, 2022

✔ NPI 1659008670 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IN · 71012743A

2100 GOSHEN RD, Fort Wayne, IN 46808

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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)

Samantha Lynne Fredrickson Fnp 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 46808 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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.

TIMOTHY JAY HILL MSED

Counselor (Mental Health)