DR. SAMANTHA JANSEN (OD) – Optometrist, NPI 1346728177

DR. SAMANTHA JANSEN (OD) is a healthcare provider. based in Chicago, Illinois. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 2166 (KS). The NPI Number for DR. SAMANTHA JANSEN (OD) is 1346728177

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
DR. SAMANTHA JANSEN (OD)
NPI
1346728177
Phone
(785) 209-0830
Address
1713 N HERMITAGE AVE APT 1G
Enumeration Date
2 August 2018
Last Update Date
6 October 2022

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
7858412020
Graduation Year
2018 (8 years ago)
PAC ID
8123378874
Group Practice PAC ID
5496871824
Professional Enrollment ID
I20250918001939
Address ID
KS660494094LA5100XPKWY401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:7State licenses:2Digital endpointsOther names

1,715 OPTOMETRY in IL

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Provider Addresses for DR. SAMANTHA JANSEN (OD)

  • 1713 N HERMITAGE AVE APT 1G

    CHICAGO, IL 606227944

    Phone: (785) 209-0830

    Type: Mailing

  • Halsted Street, Homewood, Thornton Township, Cook County, Illinois, 60430, United States

    HOMEWOOD, IL 604302508

    Phone: (708) 798-7711

    Type: Location

  • 15460 ALDRICH LN

    PERRY, KS 660734021

    Phone: (785) 209-0830

    Type: Mailing

  • 1801 SW WANAMAKER RD

    TOPEKA, KS 666043804

    Phone: (785) 272-1866

    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: 2025-09-18

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
I20250918001939IOptometryKSTBD

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 60622)

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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: 5496871824View full group profile
NameSpecialtyState
O P T O M E T R YKS
O P T O M E T R YKS
O P T O M E T R YKS
O P T O M E T R YKS
O P T O M E T R YKS
O P T O M E T R YKS
O P T O M E T R YNC
O P T O M E T R YKS

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. SAMANTHA JANSEN (OD)?
DR. SAMANTHA JANSEN (OD) — NPI 1346728177 — is the standard way to identify this listing.
Is DR. SAMANTHA JANSEN (OD) still practicing?
DR. SAMANTHA JANSEN (OD) is currently listed as active in the public NPI registry.
What is DR. SAMANTHA JANSEN (OD)'s primary classification?
Optometrist is the headline specialty for DR. SAMANTHA JANSEN (OD) here. Clinical services aligned with this taxonomy classification.
Where is DR. SAMANTHA JANSEN (OD) based?
DR. SAMANTHA JANSEN (OD) is tied to Chicago, Illinois in the data we show; additional addresses may exist on the full record.
Why does DR. SAMANTHA JANSEN (OD) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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