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DR. SAMUEL SANTELICES MD
NPI 1669476552
Pediatrics in Lake City, FL

Active since June 08, 2005PECOS Enrolled
1859 SW NEWLAND WAY, LAKE CITY, FL 32025(386) 758-0003(386) 755-7940 Get Directions Write a Review

NPPES record last updated: June 18, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 18, 2025, Jan 24, 2017 (2 updates tracked since 2017).

About Dr. Samuel Santelices Md NPPES

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

DR. SAMUEL SANTELICES MD (NPI 1669476552) is an individual pediatrics provider in Lake City, Florida, licensed in Florida (ME87551) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669476552
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. SAMUEL SANTELICESCredential: MD
Location Address1859 SW NEWLAND WAYLake City, FL 32025-6966
Mailing Address1859 Sw Newland WayLake City, FL 32025-6966 · (386) 758-0003 · Fax (386) 755-7940
Phone(386) 758-0003
Fax(386) 755-7940
Sole ProprietorNo
Enumeration DateJune 8, 2005
Last NPPES UpdateJune 18, 20252 updates tracked since enumeration
NPPES CertifiedJune 5, 2025
✔ NPI 1669476552 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in FL · ME87551
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1859 SW NEWLAND WAY, Lake City, FL 32025
Open in Google Maps ↗

Other Identifiers 1

Medicaid267374600FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama 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)

Dr. Samuel Santelices 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.

Medicare Billing Reassignment

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

North Florida Pediatrics, PA
22 mi
Rural Health
NORTH FLORIDA PEDIATRICS, PA, 1101 OHIO AVENUE SOUTH
Live Oak, FL 32064
  • Reassigned Medicare billing, Florida enrollment
  • 4 clinicians in this Medicare group
NPI 1558602482 (386) 339-1060

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 32025 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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 18

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

AMNA ZARAR M.D
Pediatrics
1859 SW NEWLAND WAY
LAKE CITY, FL 32025
Columbia County (386) 758-0003
JOURDAN ASHLEY CLUM ARNP
Nurse Practitioner (Pediatrics)
1859 SW NEWLAND WAY
LAKE CITY, FL 32025
Columbia County (386) 758-0003
GERALDINE S PALLIJA ARNP
Nurse Practitioner (Pediatrics)
1859 SW NEWLAND WAY
LAKE CITY, FL 32025
Columbia County (386) 758-0003
MS. SYDNEY TAYLOR BORG APRN
Nurse Practitioner
1859 SW NEWLAND WAY
LAKE CITY, FL 32025
Columbia County (386) 758-0003
TIFFANY ELLIS FNP
Nurse Practitioner (Family)
1859 SW NEWLAND WAY
LAKE CITY, FL 32025
Columbia County (386) 758-0003
SABRINA GREEN
Nurse Practitioner
1859 SW NEWLAND WAY
LAKE CITY, FL 32025
Columbia County (386) 758-0003
RICHARD B GIBBONS ARNP
Nurse Practitioner
1859 SW NEWLAND WAY
LAKE CITY, FL 32025
Columbia County (386) 758-0003
MS. CASEY MARIE PERRY
Nurse Practitioner (Pediatrics)
1859 SW NEWLAND WAY
LAKE CITY, FL 32025
Columbia County (386) 758-0003

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 Samuel Santelices's NPI number?

The NPI number for Samuel Santelices is 1669476552. It was assigned to this individual provider in the NPPES registry on June 8, 2005.

Where is Samuel Santelices located?

Samuel Santelices practices at 1859 SW Newland Way, Lake City, FL 32025. The listed phone number is (386) 758-0003.

What is Samuel Santelices's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Samuel Santelices enrolled in Medicare?

Yes. Samuel Santelices is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Samuel Santelices's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Santelices reassigns Medicare benefits to North Florida Pediatrics, PA (Live Oak, FL). 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 Samuel Santelices's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samuel Santelices accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 4 other insurers list Samuel Santelices 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 Samuel Santelices was last updated on June 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.