SAMMANTHA JEANE KOUBA DO
NPI 1760877344
Internal Medicine - Infectious Disease in Fargo, ND

Active since April 01, 2015PECOS EnrolledAccepts Medicare Assignment
82.99/100
CMS Quality Rating
5225 23RD AVE S, FARGO, ND 58104(701) 417-2575(701) 417-2535 Get Directions Write a Review

NPPES record last updated: April 19, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 19, 2022, Dec 2, 2020, Aug 27, 2019 and 1 more (4 updates tracked since 2016).

About Sammantha Jeane Kouba Do NPPES

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

SAMMANTHA JEANE KOUBA DO (NPI 1760877344) is an individual infectious disease provider in Fargo, North Dakota, licensed in North Dakota (16710) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS, is affiliated with Sanford Medical Center Fargo, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1760877344
Entity TypeIndividualFemale
Primary Taxonomy207RI0200X
Provider Legal NameSAMMANTHA JEANE KOUBACredential: DO
Location Address5225 23RD AVE SFargo, ND 58104-7927
Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074
Fax(701) 417-2535
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateApril 1, 2015
Last NPPES UpdateApril 19, 20224 updates tracked since enumeration
NPPES CertifiedApril 19, 2022
NPI 1760877344 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License Licensed in ND · 16710
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
Also ListedInternal MedicineTaxonomy 207R00000X · License DO-05366 (IA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License PG172349 (OR)
5225 23RD AVE S, Fargo, ND 58104

Secondary Practice Locations 3

Location 12800 N. Vancouver Ste 230Portland, OR 97227 · Phone (503) 413-7074 · Fax (503) 413-6892
Location 2736 Broadway NFargo, ND 58102-4421 · Phone (701) 234-2000
Location 3200 Hawkins DrIowa City, IA 52242-1009 · Phone (319) 356-8969 · Fax (319) 356-4600

Accepted 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

Sammantha Jeane Kouba Do 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 ID3476858440
PECOS Enrollment IDI20201016001962
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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
118 services48 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
81 services78 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.
51 services31 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Sanford Medical Center Fargo

Acute Care Hospitals · Fargo, ND
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number350011
Location801 Broadway NorthFargo, ND 58122 · Cass County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58104 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
$127.45 typical visit price
range $55.75 – $168.12
Typical copayment $31.86 (range $13.93 – $42.03)
Most-billed visit code 99204
Established Patient
$98.29 typical visit price
range $18.11 – $137.65
Typical copayment $24.57 (range $4.52 – $34.41)
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.

82.99/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.06
Promoting Interoperability99
Improvement Activities40
Cost57.08

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.

Emergency Medicine
5225 23RD AVE S
FARGO, ND 58104
Emergency Medicine
5225 23RD AVE S
FARGO, ND 58104
Internal Medicine
5225 23RD AVE S
FARGO, ND 58104
Hospitalist
5225 23RD AVE S
FARGO, ND 58104
Nurse Anesthetist, Certified Registered
5225 23RD AVE S
FARGO, ND 58104
Obstetrics & Gynecology
5225 23RD AVE S
FARGO, ND 58104
Nurse Anesthetist, Certified Registered
5225 23RD AVE S
FARGO, ND 58104
Nurse Practitioner
5225 23RD AVE S
FARGO, ND 58104

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 Sammantha Kouba's NPI number?

The NPI number for Sammantha Kouba is 1760877344. It was assigned to this individual provider in the NPPES registry on April 1, 2015.

Where is Sammantha Kouba located?

Sammantha Kouba practices at 5225 23rd Ave S, Fargo, ND 58104. The listed phone number is (701) 417-2575.

What is Sammantha Kouba's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Sammantha Kouba enrolled in Medicare?

Yes. Sammantha Kouba 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.

What insurance does Sammantha Kouba accept?

Health plans from Blue Cross Blue Shield of North Dakota, Medica, Sanford Health Plan and Security Health Plan list Sammantha Kouba 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.

Is Sammantha Kouba affiliated with any hospitals?

According to CMS data, Sammantha Kouba is affiliated with Sanford Medical Center Fargo.

When was this NPI record last updated?

The NPPES record for Sammantha Kouba was last updated on April 19, 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.