DR. SAMANTHA JUANITA VICKERS (DNP, CRNA) – Certified Registered Nurse Anesthetist, NPI 1417429523
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,360 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in FL
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Provider Addresses for DR. SAMANTHA JUANITA VICKERS (DNP, CRNA)
47, Loggerhead Lane, Palm Valley, Ponte Vedra, St. Johns County, Florida, 32082, United States
PONTE VEDRA, FL 320822585
Phone: (315) 651-0047
Type: Mailing
Memorial Hospital, 3625, University Boulevard South, Englewood, Jacksonville, Duval County, Florida, 32216, United States
JACKSONVILLE, FL 322164207
Phone: (904) 702-6111
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: 2019-03-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190319002565 | I | Certified Registered Nurse Anesthetist (Crna) | FL | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36620 | Insertion of artery tube for blood sampling or infusion through skin | 21 | 21 | $0 |
| 93503 | Insertion of tube in pulmonary artery for monitoring | 11 | 11 | $0 |
Insurance plans in this area (ZIP 32082)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| Certified Registered Nurse Anesthetist (Crna) | MS | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| Anesthesiology Assistant | FL | |
| A N E S T H E S I O L O G Y | FL | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| Certified Registered Nurse Anesthetist (Crna) | NY |
Reviews
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