MRS. TRACI DAWN SAMBOLIN (NP) – Adult Health Nurse Practitioner, NPI 1457668295
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
Provider Addresses for MRS. TRACI DAWN SAMBOLIN (NP)
54 Hospital Dr
Osage Beach, MO 650653050
Phone: (573) 302-2800
Type: Location
1 HOSPITAL DR # CE306
COLUMBIA, MO 652121000
Phone: (573) 882-8863
Type: Mailing
5305 WESTWARD LN
JEFFERSON CITY, MO 651091550
Phone: (573) 433-0738
Type: Mailing
800 HOSPITAL DR
COLUMBIA, MO 652015275
Phone: (573) 838-0847
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 91 Open Payments records for all available years, with a total value of $1,887.
Total Amount is formed as General ($1,887) + Research ($0) + Ownership ($0) = $1,887.
Last reported payment date: 2024-06-09 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($308).
Total Amount
$1,887
General + Research + Ownership
Payments
91
Total payment records
General Amount
$1,887
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-09
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2013-08-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130809000690 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 285 | 107 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 56 | 31 | $0 |
Insurance plans in this area (ZIP 65065)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MO | |
| - | MO | |
| Family Practice | MO | |
| Emergency Medicine, Internal Medicine | MO | |
| Emergency Medicine | FL | |
| Emergency Medicine | MO | |
| Emergency Medicine | IL | |
| Emergency Medicine | CA | |
| Family Practice | MO | |
| Emergency Medicine | FL |
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