SAMANTHA DAWN SURACE (FAMILY NURSE PRACTIT) – Registered Nurse, NPI 1518234111
Registered Nurse
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Profile Insights
NPPES metrics only — not quality of care.
16,993 NURSE PRACTITIONER in NY
Provider Addresses for SAMANTHA DAWN SURACE (FAMILY NURSE PRACTIT)
5380 TECH DATA DR STE 101
CLEARWATER, FL 337603122
Phone: (845) 269-5740
Type: Mailing
21 LOUISE DR
WEST NYACK, NY 109941911
Phone: (845) 269-5740
Type: Location
2776 CLEVELAND AVE
FORT MYERS, FL 339015864
Phone: (239) 343-1614
Fax: (239) 343-3695
Type: Location
9820 Hutchinson Park Drive
Jacksonville, FL 32225
Phone: (904) 450-6740
Type: Location
21 Louise Dr
West Nyack, NY 109941911
Phone: (845) 269-5740
Type: Location
PO BOX 2147
FORT MYERS, FL 339022147
Phone: (239) 343-1614
Fax: (239) 343-3695
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: 2020-07-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20170407001180 | I | Nurse Practitioner | NY | TBD |
| I20200714000549 | I | Nurse Practitioner | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 36 | 36 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 34 | 33 | $0 |
Insurance plans in this area (ZIP 33760)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| R H E U M A T O L O G Y | FL | |
| Nurse Practitioner | FL | |
| Critical Care (Intensivists), Pediatric Medicine | FL | |
| General Surgery | MI | |
| N E U R O L O G Y | MO | |
| Medical Genetics And Genomics | MI | |
| Nurse Practitioner | FL | |
| Family Practice | FL | |
| General Surgery | FL | |
| Family Practice | FL |
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