DR. JEFFREY NEIL SAMUELSON (M.D.) – MOHS-Micrographic Surgery Physician, NPI 1407912678

DR. JEFFREY NEIL SAMUELSON (M.D.) is a healthcare provider. based in Duluth, Minnesota. specializing in MICROGRAPHIC DERMATOLOGIC SURGERY (MDS). They hold the professional credentials M.D.. They hold a License No. 40515 (MN). The NPI Number for DR. JEFFREY NEIL SAMUELSON (M.D.) is 1407912678

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. JEFFREY NEIL SAMUELSON (M.D.)
NPI
1407912678
Phone
(952) 898-1600
Address
1414 WOODLAND AVE
Enumeration Date
29 December 2006
Last Update Date
13 October 2020

Doctor Profile

Medical School Name
R FRANKLIN UNIVERSITY OF MED & SCI/CHICAGO MEDICAL SCHOOL
Secondary Phone
2183021000
Graduation Year
1989 (37 years ago)
PAC ID
1759566086
Group Practice PAC ID
0244542454
Professional Enrollment ID
I20110429000436
Address ID
MN558032624DU1414XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness75
Years active:19State licenses:1Digital endpointsOther names

49 MICROGRAPHIC DERMATOLOGIC SURGERY (MDS) in MN

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Provider Addresses for DR. JEFFREY NEIL SAMUELSON (M.D.)

  • 1414, Woodland Avenue, Hunters Park, Duluth, Saint Louis County, Minnesota, 55803, United States

    DULUTH, MN 558032624

    Phone: (952) 898-1600

    Mailing address matches the actual address.

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: 2023-10-17 • Largest payer in this snapshot: STRATA Skin Sciences, Inc. ($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

2023-10-17

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: 2011-04-29

PECOS data refreshed: 2026-06-15

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
I20110429000436IMicrographic Dermatologic Surgery (Mds)MNTBD

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
17311Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks7162$0
13132Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm3230$0
17312Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks2919$0
13121Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm1211$0
View full utilization report →

Insurance plans in this area (ZIP 55803)

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Provider's Procedures

DR. JEFFREY NEIL SAMUELSON (M.D.) performs procedures in MICROGRAPHIC DERMATOLOGIC SURGERY (MDS). See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYMN13132Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet3736

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: 0244542454View full group profile
NameSpecialtyState
Nurse PractitionerMN
Nurse PractitionerMN
Nurse PractitionerMN
Nurse PractitionerMN
Nurse PractitionerMN
Nurse PractitionerMN
Physician AssistantMN

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Frequently asked questions

What is DR. JEFFREY NEIL SAMUELSON (M.D.)'s NPI number?
DR. JEFFREY NEIL SAMUELSON (M.D.)'s NPI is 1407912678 — the number used across U.S. healthcare to identify this provider.
Is DR. JEFFREY NEIL SAMUELSON (M.D.) still an active registrant?
DR. JEFFREY NEIL SAMUELSON (M.D.) carries an active NPI according to the public dataset.
What expertise is attributed to DR. JEFFREY NEIL SAMUELSON (M.D.)?
DR. JEFFREY NEIL SAMUELSON (M.D.)'s specialty line reads MOHS-Micrographic Surgery Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. JEFFREY NEIL SAMUELSON (M.D.)?
Travel planning: use Duluth, Minnesota as the reference point for DR. JEFFREY NEIL SAMUELSON (M.D.), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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