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SAMANTHA PEDERSEN RN
NPI 1871284737
Nurse Practitioner in Prosser, WA

Active since May 19, 2023PECOS Enrolled
336 CHARDONNAY AVE STE A, PROSSER, WA 99350(509) 786-1576 Get Directions Write a Review

NPPES record last updated: June 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 15, 2023, May 19, 2023 (2 updates tracked since 2023).

About Samantha Pedersen Rn NPPES

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

SAMANTHA PEDERSEN RN (NPI 1871284737) is an individual nurse practitioner in Prosser, Washington, licensed in Washington (AP61453730) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871284737
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameSAMANTHA PEDERSENCredential: RN
Location Address336 CHARDONNAY AVE STE AProsser, WA 99350-9515
Mailing Address336 Chardonnay AveProsser, WA 99350-9515
Phone(509) 786-1576
Sole ProprietorYes
Enumeration DateMay 19, 2023
Last NPPES UpdateJune 15, 20232 updates tracked since enumeration
NPPES CertifiedMay 19, 2023
✔ NPI 1871284737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in WA · AP61453730
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.
336 CHARDONNAY AVE STE A, Prosser, WA 99350
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Pedersen Rn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 99350 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
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 12

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

ZACHARY RYAN GARLAND MSN, ARNP, FNP-C
Nurse Practitioner
336 CHARDONNAY AVE STE A
PROSSER, WA 99350
Benton County (509) 786-1576
WALLA WALLA GENERAL HOSPITAL
Clinic/Center (Multi-Specialty)
336 CHARDONNAY AVE STE A
PROSSER, WA 99350
Benton County (509) 786-2002
PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY
Clinic/Center (Rural Health)
336 CHARDONNAY AVE STE A
PROSSER, WA 99350
Benton County (509) 786-1576
EMMALEE MASON MS CF-SLP
Speech-Language Pathologist
336 CHARDONNAY AVE STE A
PROSSER, WA 99350
Benton County (509) 786-1576
BONNIE BAIR
Occupational Therapist
336 CHARDONNAY AVE STE A
PROSSER, WA 99350
Benton County (509) 786-1576
DR. RALPH G LARAISO D.O.
Physical Medicine & Rehabilitation
336 CHARDONNAY AVE STE A
PROSSER, WA 99350
Benton County (509) 786-1576
DANIELLE CRAWFORD CPNP-PC, ARNP
Nurse Practitioner (Pediatrics)
336 CHARDONNAY AVE STE A
PROSSER, WA 99350
Benton County (509) 750-4058
JONATHON FOX
Family Medicine
336 CHARDONNAY AVE STE A
PROSSER, WA 99350
Benton County (509) 786-1576

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 Pedersen's NPI number?

The NPI number for Samantha Pedersen is 1871284737. It was assigned to this individual provider in the NPPES registry on May 19, 2023.

Where is Samantha Pedersen located?

Samantha Pedersen practices at 336 Chardonnay Ave Ste A, Prosser, WA 99350. The listed phone number is (509) 786-1576.

What is Samantha Pedersen's specialty?

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

Is Samantha Pedersen enrolled in Medicare?

Yes. Samantha Pedersen is registered in the Medicare PECOS enrollment system.

What insurance does Samantha Pedersen accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Samantha Pedersen 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 Pedersen was last updated on June 15, 2023. 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.