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

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: October 25, 2026.

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
Open in Google Maps ↗

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

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

Bowen Health Inc
4.4 mi
Federally Qualified Health Center (FQHC)
201 E RUDISILL BLVD
Fort Wayne, IN 46806
  • Reassigned Medicare billing, Indiana enrollment
  • 260 clinicians in this Medicare group
NPI 1023668183 (800) 342-5653

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 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)
2100 GOSHEN RD
FORT WAYNE, IN 46808
Allen County (260) 471-3500
WINELL JORDAN MA
Counselor (Mental Health)
2100 GOSHEN RD
FORT WAYNE, IN 46808
Allen County (260) 471-3500
MRS. EUNICE WANJIKU HAHN PMHNP
Psychiatry & Neurology (Psychiatry)
2100 GOSHEN RD
FORT WAYNE, IN 46808
Allen County (260) 206-7830
TAYLOR GABLER MA
Counselor (Mental Health)
2100 GOSHEN RD
FORT WAYNE, IN 46808
Allen County (260) 471-3500
MARKITA R POWELL
Counselor
2100 GOSHEN RD
FORT WAYNE, IN 46808
Allen County (260) 471-3500
JADE E. BROWN MSSW
Social Worker (Clinical)
2100 GOSHEN RD
FORT WAYNE, IN 46808
Allen County (260) 471-3500
ABIGAIL ATAKEY MA
Counselor
2100 GOSHEN RD
FORT WAYNE, IN 46808
Allen County (260) 471-3500
MS. CAROL ANNE MCKINNEY MA
Counselor
2100 GOSHEN RD
FORT WAYNE, IN 46808
Allen County (260) 471-3500

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 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.

Where is Samantha Fredrickson located?

Samantha Fredrickson practices at 2100 Goshen Rd, Fort Wayne, IN 46808. The listed phone number is (260) 471-3500.

What is Samantha Fredrickson's specialty?

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

Is Samantha Fredrickson enrolled in Medicare?

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

Which organization bills Medicare for Samantha Fredrickson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Fredrickson reassigns Medicare benefits to Bowen Health Inc (Fort Wayne, IN). 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 Fredrickson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samantha Fredrickson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Samantha Fredrickson 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 Samantha Fredrickson was last updated on August 1, 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.