SAMUEL ALBERT TANCREDI (D.D.S.) – Oral and Maxillofacial Surgery (Dentist), NPI 1073783478
Oral and Maxillofacial Surgery (Dentist)
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
42 ORAL SURGERY in IN
Provider Addresses for SAMUEL ALBERT TANCREDI (D.D.S.)
2647 Waterfront Parkway East Dr Ste 200
Indianapolis, IN 462142020
Phone: (317) 297-1007
Fax: (317) 405-8694
Type: Location
Indiana Oral & Maxillofacial Surgery Associates, 10972, Allisonville Road, Fishers, Hamilton County, Indiana, 46038, United States
SUITE 110
FISHERS, IN 460382637
Phone: (317) 913-2363
Fax: (317) 913-2360
Type: Mailing
North Meridian Street, Spring Mill Woods, Indianapolis, Indiana, 46074:46260, United States
STE. 300
INDIANAPOLIS, IN 462601880
Phone: (317) 846-7377
Fax: (317) 846-8566
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: 2008-07-16
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 |
|---|---|---|---|---|
| I20080716000050 | I | Oral Surgery | IN | 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 |
|---|---|---|---|---|
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 23 | 23 | $0 |
Insurance plans in this area (ZIP 46214)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Maxillofacial Surgery, Oral Surgery | IN | |
| - | IN | |
| Maxillofacial Surgery, Oral Surgery | IN | |
| Maxillofacial Surgery, Oral Surgery | IN | |
| Maxillofacial Surgery, Oral Surgery | IN | |
| Maxillofacial Surgery | IN | |
| Maxillofacial Surgery | IN | |
| - | IN | |
| - | IN | |
| Maxillofacial Surgery | IN |
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