MRS. SAMANTHA ROSE PETROVSKI – Certified Registered Nurse Anesthetist, NPI 1861978108

MRS. SAMANTHA ROSE PETROVSKI is a healthcare provider. based in Shelby township, Michigan. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 4704294114 (MI). The NPI Number for MRS. SAMANTHA ROSE PETROVSKI is 1861978108

Main info

Female
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
MRS. SAMANTHA ROSE PETROVSKI
NPI
1861978108
Phone
Not provided
Address
54835 PELICAN LN
Enumeration Date
18 July 2018
Last Update Date
19 December 2023

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3137453615
Graduation Year
2018 (8 years ago)
PAC ID
5890031686
Group Practice PAC ID
9638481591
Professional Enrollment ID
I20190116000756
Address ID
MI482012153DE4201XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:7State licenses:1Digital endpointsOther names

2,692 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MI

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Provider Addresses for MRS. SAMANTHA ROSE PETROVSKI

  • Pelican Lane, Preston Corners, Shelby Charter Township, Macomb County, Michigan, 48315, United States

    SHELBY TOWNSHIP, MI 483156939

    Phone:

    Type: Mailing

  • 700 S REMBRANDT AVE

    ROYAL OAK, MI 480672987

    Phone:

    Type: Mailing

  • 24711 BROOKSHIRE DR

    MACOMB, MI 480424745

    Phone: (586) 722-8251

    Type: Mailing

  • DMC Sinai-Grace Hospital, 6071, West Outer Drive, Northwest Detroit, Detroit, Wayne County, Michigan, 48235, United States

    DETROIT, MI 482352624

    Phone: (313) 966-3300

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $71.

Total Amount is formed as General ($71) + Research ($0) + Ownership ($0) = $71.

Last reported payment date: 2024-08-08 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($50).

Total Amount

$71

General + Research + Ownership

Payments

4

Total payment records

General Amount

$71

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-08

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: 2019-01-16

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
I20190116000756ICertified Registered Nurse Anesthetist (Crna)MITBD

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 endoscope2828$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1818$0
00813Anesthesia for procedure on small and large bowel using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 48315)

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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: 9638481591View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)IL
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
-MI
-MI
Anesthesiology, Critical Care (Intensivists)MI
Certified Registered Nurse Anesthetist (Crna)IL
Certified Registered Nurse Anesthetist (Crna)MI
A N E S T H E S I O L O G YMI

Reviews

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Frequently asked questions

What number should I use to identify MRS. SAMANTHA ROSE PETROVSKI for billing?
Administrative and clinical systems typically use NPI 1861978108 for MRS. SAMANTHA ROSE PETROVSKI.
Is MRS. SAMANTHA ROSE PETROVSKI currently accepting referrals based on NPI status?
Registry metadata lists MRS. SAMANTHA ROSE PETROVSKI as active.
What does the directory say MRS. SAMANTHA ROSE PETROVSKI does?
Insurance directories may phrase it differently, but here MRS. SAMANTHA ROSE PETROVSKI maps to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MRS. SAMANTHA ROSE PETROVSKI?
MRS. SAMANTHA ROSE PETROVSKI is associated with Shelby Township, Michigan in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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