MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC) – Family Nurse Practitioner, NPI 1154968667

MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC) is a healthcare provider. based in Pontiac, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-BC. They hold a License No. 4704311772 (MI). The NPI Number for MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC) is 1154968667

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC)
NPI
1154968667
Phone
(248) 338-5516
Address
50 N PERRY ST
Enumeration Date
3 December 2019
Last Update Date
2 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8669529003
Graduation Year
2019 (7 years ago)
PAC ID
4587098363
Group Practice PAC ID
8820242993
Professional Enrollment ID
I20200103000109
Address ID
MI480844771TR888XXRDXX501
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness75
Years active:6State licenses:1Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

Provider Addresses for MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC)

  • 50 N PERRY ST

    PONTIAC, MI 483422217

    Phone: (248) 338-5516

    Type: Mailing

  • 888 W. BIG BEAVER RD. STE 900

    TROY, MI 48084

    Phone: (248) 629-2880

    Fax: (248) 319-6493

    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: 2020-01-03

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
I20200103000109INurse PractitionerMITBD

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
99497Advance care planning, first 30 minutes10068$0
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes9041$0
99350Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes4325$0
99443Telephone medical discussion with physician, 21-30 minutes3514$0
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes3123$0
View full utilization report →

Insurance plans in this area (ZIP 48342)

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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: 8820242993View full group profile
NameSpecialtyState
Nurse PractitionerMI
-MI
Nurse PractitionerMI

Reviews

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Frequently asked questions

What is the standard ID for MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC) in the U.S.?
In the U.S., MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC) is identified by NPI 1154968667.
Should I treat MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC) as an active provider?
Patients and plans typically see MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC) as active in the national extract.
What services align with MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC)'s listing?
MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC)'s public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC) tied to Pontiac, Michigan?
If you are local to Pontiac, Michigan, MRS. SAMANTHA MICHELLE KACZMAREK (FNP-BC) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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