MIRANDA WHITLEY SAMSON – Physical Medicine & Rehabilitation Physician, NPI 1205475670

MIRANDA WHITLEY SAMSON is a healthcare provider. based in Boulder, Colorado. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. PTL.0016778 (CO). The NPI Number for MIRANDA WHITLEY SAMSON is 1205475670

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
MIRANDA WHITLEY SAMSON
NPI
1205475670
Phone
(720) 443-9812
Address
850 W MOORHEAD CIR APT 3J
Enumeration Date
2 January 2020
Last Update Date
8 April 2025

Doctor Profile

Medical School Name
UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, AURORA
Secondary Phone
3039381141
Graduation Year
2019 (7 years ago)
PAC ID
9032544838
Group Practice PAC ID
6002882339
Professional Enrollment ID
I20200125000030
Address ID
CO803016148BO3020XPLXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

2,988 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CO

Provider Addresses for MIRANDA WHITLEY SAMSON

  • 850 W MOORHEAD CIR APT 3J

    BOULDER, CO 803056169

    Phone: (720) 443-9812

    Type: Mailing

  • 315 W SOUTH BOULDER RD

    LOUISVILLE, CO 800271156

    Phone: (303) 666-4151

    Type: Location

  • 1325 DRY CREEK DR STE 204

    LONGMONT, CO 805037748

    Phone: (303) 938-1141

    Type: Mailing

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: 2020-01-25

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
I20200125000030IPhysical Therapist In Private 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities9923$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes7922$0
97535Training for self-care or home management, each 15 minutes7223$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes6418$0
97140Therapy procedure using manual technique, each 15 minutes6412$0
View full utilization report →

Insurance plans in this area (ZIP 80305)

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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: 6002882339View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMT
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
-CO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeMT

Reviews

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Frequently asked questions

Can I use this page to confirm MIRANDA WHITLEY SAMSON's NPI?
Yes. MIRANDA WHITLEY SAMSON is listed with NPI 1205475670 in the public NPI dataset.
Does the file indicate MIRANDA WHITLEY SAMSON is practicing under active NPI?
Directory data currently reports MIRANDA WHITLEY SAMSON as active.
What is MIRANDA WHITLEY SAMSON's primary classification?
Physical Medicine & Rehabilitation Physician is the headline specialty for MIRANDA WHITLEY SAMSON here. Clinical services aligned with this taxonomy classification.
What area does MIRANDA WHITLEY SAMSON serve?
MIRANDA WHITLEY SAMSON's listing highlights Boulder, Colorado; more addresses can appear in NPPES.
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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