SAMANTHA FRANCES JEZESKI (NP) – Family Medicine Physician, NPI 1043775570
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
887 NURSE PRACTITIONER in HI
Provider Addresses for SAMANTHA FRANCES JEZESKI (NP)
100 WAILEA IKE DR
KIHEI, HI 967539514
Phone:
Type: Mailing
2925 CHICAGO AVE
MINNEAPOLIS, MN 554071321
Phone: (612) 262-9000
Type: Mailing
701 DELLWOOD ST S
CAMBRIDGE, MN 550081920
Phone: (763) 689-8700
Type: Location
2134 Bunker Lake Blvd NW Ste 100
Andover, MN 553043910
Phone: (763) 754-4396
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: 2022-07-07
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 |
|---|---|---|---|---|
| I20220707003826 | I | Nurse Practitioner | MN | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 37 | 37 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 22 | 22 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 19 | 19 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 13 | 13 | $0 |
| 81003 | Automated urinalysis test | 12 | 11 | $0 |
Insurance plans in this area (ZIP 96753)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease | CO | |
| Qualified Audiologist | MN | |
| Family Practice | MN | |
| - | MN | |
| Family Practice | MN | |
| Nurse Practitioner | ND | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN |
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