SAMANTHA HERRIN (PA-C) – Physician Assistant, NPI 1245953967
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for SAMANTHA HERRIN (PA-C)
109 CALIFORNIA ST, PO BOX 577
CARTERVILLE, IL 629180577
Phone: (618) 519-9200
Fax: (618) 985-4635
Type: Mailing
PO BOX 577
CARTERVILLE, IL 629180577
Phone: (618) 519-9200
Fax: (618) 985-4635
Type: Mailing
404 S LEWIS LN
CARBONDALE, IL 629013547
Phone: (618) 519-9200
Fax: (618) 549-1288
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 21 Open Payments records for all available years, with a total value of $418.
Total Amount is formed as General ($418) + Research ($0) + Ownership ($0) = $418.
Last reported payment date: 2024-11-22 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($146).
Total Amount
$418
General + Research + Ownership
Payments
21
Total payment records
General Amount
$418
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-22
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2022-10-10
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 |
|---|---|---|---|---|
| I20221010000112 | I | Physician Assistant | IL | 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 |
|---|---|---|---|---|
| 81003 | Automated urinalysis test | 16 | 14 | $0 |
Insurance plans in this area (ZIP 62918)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Nurse Midwife (Cnm) | IL | |
| - | IL | |
| Nurse Practitioner | IL | |
| Clinical Social Worker | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Mental Health Counselor | IL | |
| Internal Medicine | NJ | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL |
Reviews
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