SAMANTHA R KAUCHAK APRN
NPI 1689398521
Nurse Practitioner in Rockford, IL

Q: What is Samantha Kauchak's NPI number?

The NPI number for Samantha Kauchak is 1689398521. It was assigned to this individual provider in the NPPES registry on October 3, 2022.

Q: What is Samantha Kauchak's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Kauchak was last updated on June 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 50 days 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.

Active since October 03, 2022PECOS EnrolledAccepts Medicare Assignment

5875 E RIVERSIDE BLVD, ROCKFORD, IL 61114(815) 398-9491(815) 381-7498 Get Directions Write a Review

NPPES record last updated: June 16, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 17, 2024, Nov 15, 2024, Nov 4, 2022 and 1 more (4 updates tracked since 2022).

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About Samantha R Kauchak Aprn NPPES

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

SAMANTHA R KAUCHAK APRN (NPI 1689398521) is an individual nurse practitioner in Rockford, Illinois, licensed in Illinois (209026147) and active in the NPI registry since October 2022. She is enrolled in Medicare PECOS, is affiliated with Uw Health, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1689398521

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameSAMANTHA R KAUCHAKCredential: APRN

Location Address5875 E RIVERSIDE BLVDRockford, IL 61114-4937

Mailing AddressPo Box 735263Chicago, IL 60673-5263 · (815) 398-9491 · Fax (815) 381-7498

Phone(815) 398-9491

Fax(815) 381-7498

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateOctober 3, 2022

Last NPPES UpdateJune 16, 20264 updates tracked since enumeration

NPPES CertifiedJune 16, 2026

✔ NPI 1689398521 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IL · 209026147

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered NurseTaxonomy 163W00000X · License 041428462 (IL)

5875 E RIVERSIDE BLVD, Rockford, IL 61114

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware 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 and accepts Medicare assignment

Samantha R Kauchak Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214307024

PECOS Enrollment IDI20230111002318

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

146 services142 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

21 services21 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Uw Health

Acute Care Hospitals · Rockford, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140228

Location1401 East State StreetRockford, IL 61104 · Winnebago County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61114 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

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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.

DR. LIZA A DAFCHAHI SHIRANI MD

Anesthesiology