SUNIL SAM (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1366934176
Psychiatric/Mental Health Nurse Practitioner
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
Provider Addresses for SUNIL SAM (PMHNP)
851 E 5th St Ste 154
Washington, MO 630903136
Phone: (314) 251-6663
Type: Location
10018 Kennerly Rd
Saint Louis, MO 631282106
Phone: (314) 251-6663
Type: Location
615 S New Ballas Rd
Saint Louis, MO 631418221
Phone: (314) 251-6663
Type: Location
137, South Windham Lane, Bloomingdale, DuPage County, Illinois, 60108, United States
BLOOMINGDALE, IL 601082534
Phone: (630) 303-0383
Type: Mailing
Saint Bernard Hospital, 326, West 64th Street, Englewood, Chicago, Lake Township, Cook County, Illinois, 60621, United States
CHICAGO, IL 606213114
Phone: (773) 962-3900
Type: Location
1400 US HIGHWAY 61
FESTUS, MO 630284100
Phone: (314) 251-6663
Type: Location
136 S WINDHAM LN
BLOOMINGDALE, IL 601082536
Phone: (630) 765-4073
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: 2025-05-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200602002902 | I | Nurse Practitioner | IL | TBD |
| I20250506002882 | I | Nurse Practitioner | MO | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 65 | 35 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 43 | 36 | $0 |
| 90791 | Psychiatric diagnostic evaluation | 19 | 18 | $0 |
Insurance plans in this area (ZIP 63090)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Diagnostic Radiology, Cardiovascular Disease (Cardiology), Internal Medicine | IL | |
| G A S T R O E N T E R O L O G Y | IL | |
| P S Y C H I A T R Y | IL | |
| General Surgery | IL | |
| Orthopedic Surgery | IN | |
| Pulmonary Disease, Critical Care (Intensivists), Internal Medicine | IL | |
| Ophthalmology, Plastic And Reconstructive Surgery | IL | |
| P O D I A T R Y | IL | |
| P S Y C H I A T R Y | IL |
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