MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.) – Certified Registered Nurse Anesthetist, NPI 1194134114
Certified Registered Nurse Anesthetist
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Profile Insights
NPPES metrics only — not quality of care.
1,311 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MA
Provider Addresses for MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.)
55 FRUIT ST
BOSTON, MA 021142621
Phone: (617) 724-4910
Type: Location
76 H ST
BOSTON, MA 021274408
Phone:
Type: Mailing
200 W Arbor Dr
San Diego, CA 921039000
Phone: (800) 926-8273
Type: Location
995 Gateway Center Way Ste 207
San Diego, CA 921024544
Phone: (619) 263-9729
Fax: (619) 263-9730
Type: Location
PO BOX 232410
SAN DIEGO, CA 921932410
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2023-03-18 • Largest payer in this snapshot: Pacira Pharmaceuticals Incorporated ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Pacira Pharmaceuticals Incorporated | $15 |
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: 2021-11-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20160914000800 | I | Certified Registered Nurse Anesthetist (Crna) | MA | TBD |
| I20211109001739 | I | Certified Registered Nurse Anesthetist (Crna) | CA | 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 |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 14 | 14 | $0 |
Insurance plans in this area (ZIP 02114)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | CA | |
| Certified Registered Nurse Anesthetist (Crna) | CA | |
| Certified Registered Nurse Anesthetist (Crna) | CA |
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