DR. SAMANTHA POUPORE (MD) – Family Medicine Physician, NPI 1184150864

DR. SAMANTHA POUPORE (MD) is a healthcare provider. based in Greeley, Colorado. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. DR.0061291 (CO). The NPI Number for DR. SAMANTHA POUPORE (MD) is 1184150864

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
DR. SAMANTHA POUPORE (MD)
NPI
1184150864
Phone
(970) 378-8000
Address
6801 W 20TH ST UNIT 101
Enumeration Date
2 May 2017
Last Update Date
1 April 2025

Doctor Profile

Medical School Name
CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9705877881
Graduation Year
2017 (9 years ago)
PAC ID
1951669282
Group Practice PAC ID
0143115691
Professional Enrollment ID
I20190820001594
Address ID
CO805347859JO473XXAVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

2,661 FAMILY PRACTICE in CO

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Provider Addresses for DR. SAMANTHA POUPORE (MD)

  • 6801 W 20TH ST UNIT 101

    GREELEY, CO 806349640

    Phone: (970) 378-8000

    Fax: (970) 378-8088

    Type: Mailing

  • 1600, 23rd Avenue, Greeley, Weld County, Colorado, 80634, United States

    GREELEY, CO 806346070

    Phone: (970) 810-2424

    Fax: (970) 810-2774

    Type: Mailing

  • 473 CASTLE PINES AVE STE 1

    JOHNSTOWN, CO 805347859

    Phone: (970) 587-7881

    Fax: (970) 587-7738

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2019-08-20

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
I20190820001594IFamily PracticeCOTBD

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 80634)

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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: 0143115691View full group profile
NameSpecialtyState
-CO
Physician AssistantCO
Family PracticeCO
Family PracticeAZ
Family PracticeCO
Family PracticeCO
Family Practice, Sports MedicineCO
Family PracticeCO
Family PracticeCO
Family PracticeCO

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

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Frequently asked questions

What is the 10-digit NPI for DR. SAMANTHA POUPORE (MD)?
DR. SAMANTHA POUPORE (MD) — NPI 1184150864 — is the standard way to identify this listing.
Can I rely on DR. SAMANTHA POUPORE (MD) being an active provider?
As of the registry snapshot, DR. SAMANTHA POUPORE (MD) is marked active.
What is DR. SAMANTHA POUPORE (MD)'s primary classification?
Family Medicine Physician is the headline specialty for DR. SAMANTHA POUPORE (MD) here. Clinical services aligned with this taxonomy classification.
Where is DR. SAMANTHA POUPORE (MD) based?
DR. SAMANTHA POUPORE (MD) is tied to Greeley, Colorado in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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