SAMANTHA RAE SELLKE – Family Nurse Practitioner, NPI 1669948964
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SAMANTHA RAE SELLKE
1501 Golden Gate Plz
Mayfield Heights, OH 441243415
Phone: (440) 565-4344
Type: Location
5812 Ridge Rd
Parma, OH 441293161
Phone: (866) 389-2727
Type: Location
11706 Clifton Blvd
Lakewood, OH 441072018
Phone: (866) 389-2727
Type: Location
5812, Ridge Road, Polish Village, Parma, Cuyahoga County, Ohio, 44129, United States
PARMA, OH 441293161
Phone: (866) 389-2727
Type: Location
155 CROCKER PARK BLVD
WESTLAKE, OH 441456987
Phone: (440) 575-5762
Type: Location
4652, West Park Drive, Fairview Park, Cuyahoga County, Ohio, 44126, United States
FAIRVIEW PARK, OH 441262348
Phone: (440) 479-0345
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: 2018-12-11
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 |
|---|---|---|---|---|
| I20181211002908 | I | Nurse Practitioner | OH | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 44124)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| - | OH | |
| - | OH |
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