SAMANTHA HINDERKS – Professional Counselor, NPI 1093199945

SAMANTHA HINDERKS is a healthcare provider. based in Roseville, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. 01283 (MN). The NPI Number for SAMANTHA HINDERKS is 1093199945

Main info

Female
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
SAMANTHA HINDERKS
NPI
1093199945
Phone
(651) 208-7753
Address
2233 HAMLINE AVE N
Enumeration Date
9 July 2015
Last Update Date
9 July 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6513306205
Graduation Year
2012 (14 years ago)
PAC ID
9931537826
Group Practice PAC ID
4688002579
Professional Enrollment ID
I20231226000407
Address ID
MN551133181RO2565XNXXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

1,813 MENTAL HEALTH COUNSELOR in MN

Provider Addresses for SAMANTHA HINDERKS

  • 2233 HAMLINE AVE N

    SUITE 411

    ROSEVILLE, MN 551135009

    Phone: (651) 208-7753

    Type: Location

  • 1437 BIRMINGHAM ST

    SAINT PAUL, MN 551062117

    Phone:

    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: 2023-12-26

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
I20231226000407IMental Health CounselorMNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55113)

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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: 4688002579View full group profile
NameSpecialtyState
Marriage And Family TherapistMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorMN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorWI
Marriage And Family TherapistMN

Reviews

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Frequently asked questions

What unique ID ties claims to SAMANTHA HINDERKS?
NPI 1093199945 is assigned to SAMANTHA HINDERKS under the national enumeration system.
Is SAMANTHA HINDERKS active in the national directory?
SAMANTHA HINDERKS's public NPI profile is in an active state.
What kind of provider is SAMANTHA HINDERKS?
The page reflects Professional Counselor for SAMANTHA HINDERKS. Clinical services aligned with this taxonomy classification.
What location shows for SAMANTHA HINDERKS?
We surface Roseville, Minnesota for SAMANTHA HINDERKS based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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