SAMANTHA MOORE – Gerontology Nurse Practitioner, NPI 1295626406

SAMANTHA MOORE is a healthcare provider. based in Hoffman estates, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 209-032478 (IL). The NPI Number for SAMANTHA MOORE is 1295626406

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
SAMANTHA MOORE
NPI
1295626406
Phone
Not provided
Address
1655 HIGHLAND BLVD
Enumeration Date
14 July 2025
Last Update Date
14 July 2025

Doctor Profile

Medical School Name
RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Secondary Phone
7084862700
Graduation Year
2024 (2 years ago)
PAC ID
1254848633
Group Practice PAC ID
3577578798
Professional Enrollment ID
I20250730000768
Address ID
IL603024210OA101XXSTXX339
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for SAMANTHA MOORE

  • 1655 HIGHLAND BLVD

    HOFFMAN ESTATES, IL 60169

    Phone:

    Type: Mailing

  • 101 MADISON ST

    OAK PARK, IL 603024278

    Phone: (708) 486-2700

    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: 2025-07-30

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
I20250730000768INurse PractitionerILTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60169)

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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: 3577578798View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
Internal MedicineMN
Internal MedicineIL
Hospitalist, Internal MedicineIL
Internal MedicinePA
Nurse PractitionerIL
Family PracticeIL
-IL
-IL

Reviews

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Frequently asked questions

What is the standard ID for SAMANTHA MOORE in the U.S.?
In the U.S., SAMANTHA MOORE is identified by NPI 1295626406.
Is SAMANTHA MOORE's NPI status active today?
Active status means SAMANTHA MOORE's NPI record is not deactivated in the public file.
How should patients interpret SAMANTHA MOORE's specialty?
The extract shows Gerontology Nurse Practitioner for SAMANTHA MOORE. Clinical services aligned with this taxonomy classification.
Is SAMANTHA MOORE tied to Hoffman Estates, Illinois?
If you are local to Hoffman Estates, Illinois, SAMANTHA MOORE may be relevant to your search.
Why is information missing for SAMANTHA MOORE?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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