SAMANTHA LYNN KOSTELAC FNP
NPI 1730718867
Nurse Practitioner - Family in Kansas City, MO

Q: What is Samantha Kostelac's NPI number?

The NPI number for Samantha Kostelac is 1730718867. It was assigned to this individual provider in the NPPES registry on April 1, 2020. The provider is also known as Samantha Lynn Nolker Fnp.

Q: What is Samantha Kostelac's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Samantha Kostelac was last updated on October 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since April 01, 2020PECOS EnrolledAccepts Medicare Assignment

77.28/100

CMS Quality Rating

4400 BROADWAY BLVD STE 520, KANSAS CITY, MO 64111(816) 960-7600(816) 960-7699 Get Directions Write a Review

NPPES record last updated: October 24, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 24, 2022, Jul 21, 2020, Apr 1, 2020 (3 updates tracked since 2020).

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About Samantha Lynn Kostelac Fnp NPPES

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

SAMANTHA LYNN KOSTELAC FNP (NPI 1730718867) is an individual family provider in Kansas City, Missouri, licensed in Missouri (2020022341) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS, is affiliated with Saint Luke's South Hospital, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1730718867

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSAMANTHA LYNN KOSTELACCredential: FNP

Location Address4400 BROADWAY BLVD STE 520Kansas City, MO 64111-3342

Mailing Address901 E 104th StKansas City, MO 64131-4517 · (816) 960-7600 · Fax (816) 960-7699

Phone(816) 960-7600

Fax(816) 960-7699

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateApril 1, 2020

Last NPPES UpdateOctober 24, 20223 updates tracked since enumeration

NPPES CertifiedOctober 24, 2022

✔ NPI 1730718867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

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

Taxonomy Code363LF0000X

Licenses✔ Licensed in MO · 2020022341✔ Licensed in KS · 5379596

Also ListedRegistered Nurse · Critical Care MedicineTaxonomy 163WC0200X · License 2013017085 (MO)

Also ListedRegistered Nurse · NeuroscienceTaxonomy 163WN0800X · License 2013017085 (MO)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

4400 BROADWAY BLVD STE 520, Kansas City, MO 64111

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Other Names 1

Former Name (1)Samantha Lynn Nolker Fnp

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas City, Medica, UnitedHealthcare.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 Lynn Kostelac Fnp 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 ID2668898461

PECOS Enrollment IDI20200811002093, I20200812003286

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 4

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 high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

293 services246 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.

159 services137 patients

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.

84 services78 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

26 services18 patients

Hospital Affiliations CMS Care Compare 5

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

Saint Luke's South Hospital

Acute Care Hospitals · Overland Park, KS

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number170185

Location12300 Metcalf AvenueOverland Park, KS 66213 · Johnson County

Emergency services

Saint Lukes North Hospital

Acute Care Hospitals · Kansas City, MO

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260062

Location5830 N W Barry RoadKansas City, MO 64154 · Platte County

Emergency services Birthing friendly

St Lukes Hospital Of Kansas City

Acute Care Hospitals · Kansas City, MO

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260138

Location4401 Wornall RoadKansas City, MO 64111 · Jackson County

Emergency services Birthing friendly

Saint Luke's East Hospital

Acute Care Hospitals · Lees Summit, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260216

Location100 N E Saint Luke's BoulevardLees Summit, MO 64086 · Jackson County

Emergency services Birthing friendly

Hedrick Medical Center

Critical Access Hospitals · Chillicothe, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number261321

Location2799 North Washington StreetChillicothe, MO 64601 · Livingston County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 64111 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

$85.82 typical visit price

range $55.29 – $168.52

Typical copayment $21.45 (range $13.82 – $42.13)

Most-billed visit code 99203

Established Patient

$97.82 typical visit price

range $17.60 – $137.20

Typical copayment $24.45 (range $4.40 – $34.30)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.28/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

73.71

Promoting Interoperability

100

Improvement Activities

Cost

50.58

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.

MARGARET EMILY NAYLOR RN

Nurse Practitioner (Family)