DR. PRUDENCIO GABRIEL SAMSON (MD) – Psychiatry Physician, NPI 1013045863

DR. PRUDENCIO GABRIEL SAMSON (MD) is a healthcare provider. based in Roseville, California. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. 034209 (CT). The NPI Number for DR. PRUDENCIO GABRIEL SAMSON (MD) is 1013045863

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
DR. PRUDENCIO GABRIEL SAMSON (MD)
NPI
1013045863
Phone
(860) 881-0878
Address
720 SUNRISE AVE STE 202C
Enumeration Date
2 March 2007
Last Update Date
23 January 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9167251177
Graduation Year
1987 (39 years ago)
PAC ID
1254435100
Group Practice PAC ID
8426157975
Professional Enrollment ID
I20081112000803
Address ID
CA956214700CI5959XLNXX305
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

4,134 PSYCHIATRY in CA

Provider Addresses for DR. PRUDENCIO GABRIEL SAMSON (MD)

  • 720 SUNRISE AVE STE 202C

    ROSEVILLE, CA 956614509

    Phone: (860) 881-0878

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 86 Open Payments records for all available years, with a total value of $2,110.

Total Amount is formed as General ($2,110) + Research ($0) + Ownership ($0) = $2,110.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($1,191).

Total Amount

$2,110

General + Research + Ownership

Payments

86

Total payment records

General Amount

$2,110

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-11-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20081112000803IPsychiatryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95661)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426157975View full group profile
NameSpecialtyState
Gastroenterology, Internal MedicineCA
Family Practice, Emergency MedicineCA
O B S T E T R I C S/ G Y N E C O L O G YCA
Clinical Social WorkerCA
Nurse PractitionerCA
Family PracticeCA
E N D O C R I N O L O G YCA
Internal Medicine, Pediatric MedicineCA
Physician AssistantCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

What NPI should I save for DR. PRUDENCIO GABRIEL SAMSON (MD)?
Save NPI 1013045863 if you need a stable reference for DR. PRUDENCIO GABRIEL SAMSON (MD).
Is DR. PRUDENCIO GABRIEL SAMSON (MD) currently active in the NPI registry?
CMS-published data lists DR. PRUDENCIO GABRIEL SAMSON (MD) as an active registrant.
What kind of provider is DR. PRUDENCIO GABRIEL SAMSON (MD)?
The page reflects Psychiatry Physician for DR. PRUDENCIO GABRIEL SAMSON (MD). Clinical services aligned with this taxonomy classification.
Where is DR. PRUDENCIO GABRIEL SAMSON (MD)'s primary listing?
We display Roseville, California because that is what the record indicates for DR. PRUDENCIO GABRIEL SAMSON (MD).
How can I contact DR. PRUDENCIO GABRIEL SAMSON (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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