DR. SAMANTHA JEAN SULLIVAN (PT, DPT) – Physical Therapist, NPI 1508418930
Physical Therapist
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Profile Insights
NPPES metrics only — not quality of care.
1,303 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IA
Provider Addresses for DR. SAMANTHA JEAN SULLIVAN (PT, DPT)
1810 SW White Birch Cir Ste 107
Ankeny, IA 500237226
Phone: (515) 964-8885
Fax: (515) 964-4557
Type: Location
8847 VERDON CIR
PLATTSMOUTH, NE 680484815
Phone: (402) 658-4810
Type: Mailing
Bondurant Physical Therapy and Sports Medicine, 85, Paine Street Southeast, Paine Heights, Bondurant, Polk County, Iowa, 50035, United States
BONDURANT, IA 500351154
Phone: (515) 528-2326
Fax: (515) 528-2327
Type: Location
5627 NW 86TH ST STE 200
JOHNSTON, IA 501311738
Phone: (515) 270-0303
Fax: (515) 270-0160
Type: Mailing
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: 2019-09-04
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 |
|---|---|---|---|---|
| I20190904000585 | I | Physical Therapist In Private Practice | IA | 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 |
|---|---|---|---|---|
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 231 | 31 | $0 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 230 | 30 | $0 |
| 97530 | Therapy procedure using functional activities | 221 | 28 | $0 |
| 97162 | Evaluation for physical therapy, typically 30 minutes | 17 | 14 | $0 |
Insurance plans in this area (ZIP 50023)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | IL | |
| - | IA | |
| Physical Therapist In Private Practice | IA | |
| Physical Therapist In Private Practice | IA | |
| Physical Therapist In Private Practice | IA | |
| Physical Therapist In Private Practice | IL | |
| Physical Therapist In Private Practice | IA | |
| Physical Therapist In Private Practice | IA | |
| - | IA | |
| Physical Therapist In Private Practice | IA |
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