MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.) – Certified Registered Nurse Anesthetist, NPI 1194134114

MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.) is a healthcare provider. based in Boston, Massachusetts. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials R.N.. They hold a License No. 2267172 (MA). The NPI Number for MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.) is 1194134114

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.)
NPI
1194134114
Phone
(617) 724-4910
Address
55 FRUIT ST
Enumeration Date
4 August 2014
Last Update Date
16 March 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7607356290
Graduation Year
2016 (10 years ago)
PAC ID
6204122435
Group Practice PAC ID
5799034518
Professional Enrollment ID
I20211109001739
Address ID
CA920253366ES488XXPKWY401

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness85
Years active:11State licenses:2Other namesUpdated within 12 months

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

View all Open Payments →|Open Payments Risk Radar →

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160914000800ICertified Registered Nurse Anesthetist (Crna)MATBD
I20211109001739ICertified Registered Nurse Anesthetist (Crna)CATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00811Anesthesia for other procedure on large bowel using an endoscope1414$0
View full utilization report →

Insurance plans in this area (ZIP 02114)

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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: 5799034518View full group profile
NameSpecialtyState
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

Reviews

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Frequently asked questions

Is MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.) listed with a National Provider Identifier?
Yes — MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.) has NPI 1194134114 on file in the registry.
Is MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.) still an active registrant?
MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.) carries an active NPI according to the public dataset.
What clinical focus is listed for MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.)?
At a glance, MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.) is tied to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What locale is associated with MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.)?
Directory geography for MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.) centers on Boston, Massachusetts.
Does MISS SAMANTHA ELIZABETH POLIKOWSKI (R.N.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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