MRS. DIANE K. SAMSON (PA-C) – Physician Assistant, NPI 1689627606
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for MRS. DIANE K. SAMSON (PA-C)
1324 N Sheridan Rd
Waukegan, IL 600852161
Phone: (630) 334-0968
Type: Location
13966, Redwood Street Northwest, Andover, Anoka County, Minnesota, 55304, United States
ANDOVER, MN 553044135
Phone: (630) 334-0968
Type: Mailing
West 98th Street, Bloomington, Hennepin County, Minnesota, 55438, United States
BLOOMINGTON, MN 554204773
Phone: (952) 885-6150
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: 2019-10-14
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 |
|---|---|---|---|---|
| I20191014000288 | I | Physician Assistant | 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 | 155 | 152 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 70 | 70 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 56 | 55 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 49 | 49 | $0 |
| 81001 | Manual urinalysis test with examination using microscope, automated | 40 | 40 | $0 |
Insurance plans in this area (ZIP 60085)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| - | MN | |
| - | MN | |
| Family Practice | MN | |
| Family Practice | IL | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN |
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