SAMANTHA OSTROM – Optometrist, NPI 1790672384

SAMANTHA OSTROM is a healthcare provider. based in Crown point, Indiana. specializing in OPTOMETRY. They hold a License No. 18004584A (IN). The NPI Number for SAMANTHA OSTROM is 1790672384

Main info

Organization
1 Year Of Experience
Accepts Medicare Assignment
Name
SAMANTHA OSTROM
NPI
1790672384
Phone
(219) 663-4450
Address
1861 E SUMMIT ST
Enumeration Date
18 June 2025
Last Update Date
7 August 2025

Doctor Profile

Medical School Name
INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
Secondary Phone
2196634450
Graduation Year
2025 (1 year ago)
PAC ID
1850808262
Group Practice PAC ID
9436138617
Professional Enrollment ID
I20250730001254
Address ID
IN463072768CR1861XSTXX401
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

1,126 OPTOMETRY in IN

Provider Addresses for SAMANTHA OSTROM

  • 1861 E SUMMIT ST

    CROWN POINT, IN 463072768

    Phone: (219) 663-4450

    Mailing address matches the actual address.

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
I20250730001254IOptometryINTBD

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 46307)

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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: 9436138617View full group profile
NameSpecialtyState
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIL
-IN

Reviews

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Frequently asked questions

Can I verify SAMANTHA OSTROM with an NPI only?
You can start verification with NPI 1790672384 for SAMANTHA OSTROM, then check state licensing separately.
Is SAMANTHA OSTROM still practicing?
SAMANTHA OSTROM is currently listed as active in the public NPI registry.
What is SAMANTHA OSTROM's specialty?
The listing groups SAMANTHA OSTROM with Optometrist. Clinical services aligned with this taxonomy classification.
What address line appears for SAMANTHA OSTROM?
SAMANTHA OSTROM's geographic hint is Crown Point, Indiana in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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