SHEBA SAM – Family Nurse Practitioner, NPI 1093268567
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,473 NURSE PRACTITIONER in PA
Provider Addresses for SHEBA SAM
PO BOX 829641
PHILADELPHIA, PA 191829641
Phone: (267) 370-5296
Type: Mailing
DOYLESTOWN HEALTH HOSPITALISTS
595 W. STATE STREET
DOYLESTOWN, PA 18901
Phone: (215) 345-2885
Fax: (215) 345-2552
Type: Location
Colony Drive, Winchester Park, Philadelphia, Philadelphia County, Pennsylvania, 19152, United States
PHILADELPHIA, PA 191522104
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 27 Open Payments records for all available years, with a total value of $518.
Total Amount is formed as General ($518) + Research ($0) + Ownership ($0) = $518.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($277).
Total Amount
$518
General + Research + Ownership
Payments
27
Total payment records
General Amount
$518
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
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: 2016-12-07
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 |
|---|---|---|---|---|
| I20161207000494 | I | Nurse Practitioner | PA | 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 19182)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | PA | |
| - | MI | |
| Physician Assistant | PA | |
| Hospitalist, Internal Medicine | PA | |
| Physician Assistant | PA | |
| - | PA | |
| Pulmonary Disease, Critical Care (Intensivists) | PA | |
| Physician Assistant | PA | |
| Nurse Practitioner | PA | |
| Internal Medicine, Critical Care (Intensivists) | PA |
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