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SHANDIIN ALLURA SAM
NPI 1700466950
Family Medicine in Camp Verde, AZ

Active since April 12, 2021PECOS EnrolledAccepts Medicare Assignment
2400 W DATSI ST, CAMP VERDE, AZ 86322(602) 263-1200(602) 263-1619 Get Directions Write a Review

NPPES record last updated: June 3, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 3, 2026, Jun 2, 2021, Apr 12, 2021 (3 updates tracked since 2021).

About Shandiin Allura Sam NPPES

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

SHANDIIN ALLURA SAM (NPI 1700466950) is an individual family medicine provider in Camp Verde, Arizona, licensed in Arizona (73786) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1700466950
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSHANDIIN ALLURA SAM
Location Address2400 W DATSI STCamp Verde, AZ 86322-8412
Mailing AddressPo Box 95460Cleveland, OH 44101-0033 · (602) 581-6076 · Fax (602) 263-1619
Phone(602) 263-1200
Fax(602) 263-1619
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateApril 12, 2021
Last NPPES UpdateJune 3, 20263 updates tracked since enumeration
NPPES CertifiedJune 3, 2026
✔ NPI 1700466950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AZ · 73786
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2400 W DATSI ST, Camp Verde, AZ 86322
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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

Shandiin Allura Sam 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 ID1456743863
PECOS Enrollment IDI20250407002254
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 86322 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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

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

DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
Public Health or Welfare
2400 W DATSI ST
CAMP VERDE, AZ 86322
Yavapai County (928) 567-2168

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 Shandiin Sam's NPI number?

The NPI number for Shandiin Sam is 1700466950. It was assigned to this individual provider in the NPPES registry on April 12, 2021.

Where is Shandiin Sam located?

Shandiin Sam practices at 2400 W Datsi St, Camp Verde, AZ 86322. The listed phone number is (602) 263-1200.

What is Shandiin Sam's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shandiin Sam enrolled in Medicare?

Yes. Shandiin Sam is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Shandiin Sam was last updated on June 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.