SAMANTHA MARIE BERTHERMAN OD
NPI 1790353308
Optometrist in Providence, RI

Active since June 11, 2021PECOS EnrolledAccepts Medicare Assignment
1466 BROAD ST, PROVIDENCE, RI 02905(401) 941-6221 Get Directions Write a Review

NPPES record last updated: June 25, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 25, 2021, Jun 11, 2021 (2 updates tracked since 2021).

About Samantha Marie Bertherman Od NPPES

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

SAMANTHA MARIE BERTHERMAN OD (NPI 1790353308) is an individual optometrist in Providence, Rhode Island, licensed in Rhode Island (ODTG00717) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS and is a graduate of New England College Of Optometry (2021).

NPPES Registry Identity

NPI1790353308
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameSAMANTHA MARIE BERTHERMANCredential: OD
Location Address1466 BROAD STProvidence, RI 02905-2836
Mailing Address9 Oak Ridge DrCumberland, RI 02864-3534 · (401) 595-8695
Sole ProprietorNo
Medical School CMSNew England College Of OptometryGraduated 2021
Enumeration DateJune 11, 2021
Last NPPES UpdateJune 25, 20212 updates tracked since enumeration
NPPES CertifiedJune 25, 2021
NPI 1790353308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License Licensed in RI · ODTG00717
Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

1466 BROAD ST, Providence, RI 02905

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

Samantha Marie Bertherman Od 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 ID4688076623
PECOS Enrollment IDI20210713001989
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

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.
14 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02905 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
$134.17 typical visit price
range $58.57 – $177.03
Typical copayment $33.54 (range $14.64 – $44.25)
Most-billed visit code 99204
Established Patient
$72.93 typical visit price
range $18.92 – $144.38
Typical copayment $18.23 (range $4.73 – $36.09)
Most-billed visit code 99213
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 4

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

Optometrist
1466 BROAD ST
PROVIDENCE, RI 02905
Optometrist
1466 BROAD ST
PROVIDENCE, RI 02905
Optometrist
1466 BROAD ST
PROVIDENCE, RI 02905
Optometrist
1466 BROAD ST
PROVIDENCE, RI 02905

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 Samantha Bertherman's NPI number?

The NPI number for Samantha Bertherman is 1790353308. It was assigned to this individual provider in the NPPES registry on June 11, 2021.

Where is Samantha Bertherman located?

Samantha Bertherman practices at 1466 Broad St, Providence, RI 02905. The listed phone number is (401) 941-6221.

What is Samantha Bertherman's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Samantha Bertherman enrolled in Medicare?

Yes. Samantha Bertherman 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 Samantha Bertherman accept?

Health plans from Providence Health Plan list Samantha Bertherman 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 Samantha Bertherman was last updated on June 25, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.