SAMANTHA M TAN (FNP-C) – Nurse Practitioner, NPI 1497253256

SAMANTHA M TAN (FNP-C) is a healthcare provider. based in Chicago, Illinois. specializing in Nurse Practitioner. They hold the professional credentials FNP-C. They hold a License No. 209.016922 (IL). The NPI Number for SAMANTHA M TAN (FNP-C) is 1497253256

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
SAMANTHA M TAN (FNP-C)
NPI
1497253256
Phone
(630) 469-9200
Address
1860 PAYSPHERE CIR
Enumeration Date
26 January 2018
Last Update Date
25 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4142906720
Graduation Year
2017 (9 years ago)
PAC ID
4385909977
Group Practice PAC ID
3375548191
Professional Enrollment ID
I20180601000224

Contacts

Secure Messaging
stan251737@dulyhealthandcare.direct-ci.com
FHIR Endpoint
https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Secure Messaging
stan241213@direct.myadvocateaurora.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness85
Years active:8State licenses:1Other namesUpdated within 12 months

Provider Addresses for SAMANTHA M TAN (FNP-C)

  • 1860 PAYSPHERE CIR

    CHICAGO, IL 606749262

    Phone: (630) 469-9200

    Type: Mailing

  • 808 RICKERT DR STE 103

    NAPERVILLE, IL 605400908

    Phone: (888) 963-6437

    Fax: (630) 348-3098

    Type: Location

  • 700, Thunderbird Trail, Carol Stream, DuPage County, Illinois, 60188, United States

    CAROL STREAM, IL 601889262

    Phone:

    Type: Mailing

  • 680 North Lake Shore Drive, 680, North Lake Shore Drive, Streeterville, Near North Side, Chicago, Cook County, Illinois, 60611, United States

    CHICAGO, IL 606114546

    Phone: (312) 695-6868

    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: 2018-06-01

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
I20180601000224INurse 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making111110$0
99284Emergency department visit with moderate level of medical decision making4545$0
99291Critical care, first 30-74 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 60674)

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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: 3375548191View full group profile

Reviews

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Frequently asked questions

What is the standard ID for SAMANTHA M TAN (FNP-C) in the U.S.?
In the U.S., SAMANTHA M TAN (FNP-C) is identified by NPI 1497253256.
Does the public listing show SAMANTHA M TAN (FNP-C) as active?
SAMANTHA M TAN (FNP-C)'s NPI record reflects an active status in NPPES.
Which specialty label fits SAMANTHA M TAN (FNP-C)?
NPPES ties SAMANTHA M TAN (FNP-C) to Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to SAMANTHA M TAN (FNP-C)?
The directory associates SAMANTHA M TAN (FNP-C) with Chicago, Illinois. Check all listed addresses for suites or satellite offices.
Who maintains SAMANTHA M TAN (FNP-C)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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