MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN) – Acute Care Nurse Practitioner, NPI 1700417466

MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN) is a healthcare provider. based in Greenville, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials AGACNP-BC, APRN. They hold a License No. AP144891 (TX). The NPI Number for MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN) is 1700417466

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN)
NPI
1700417466
Phone
(903) 408-5722
Address
4215 JOE RAMSEY BLVD E
Enumeration Date
31 January 2020
Last Update Date
3 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9034081470
Graduation Year
2019 (7 years ago)
PAC ID
7113357625
Group Practice PAC ID
8123310414
Professional Enrollment ID
I20200424001125
Address ID
TX752347829DA7XXXXPKWY300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

22,209 NURSE PRACTITIONER in TX

Provider Addresses for MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN)

  • 4215 JOE RAMSEY BLVD E

    GREENVILLE, TX 754017852

    Phone: (903) 408-5722

    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 $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2023-09-06 • Largest payer in this snapshot: Genentech USA, Inc. ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-06

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Genentech USA, Inc.$20
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: 2020-04-24

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
I20200424001125INurse PractitionerTXTBD

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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes420185$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes25288$0
99239Hospital discharge day management, more than 30 minutes140137$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes6665$0
99238Hospital discharge day management, 30 minutes or less1717$0
View full utilization report →

Insurance plans in this area (ZIP 75401)

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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: 8123310414View full group profile
NameSpecialtyState
Infectious Disease, Internal MedicineTX
Physician AssistantTX
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What unique ID ties claims to MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN)?
NPI 1700417466 is assigned to MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN) under the national enumeration system.
Is MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN) currently active in the NPI registry?
CMS-published data lists MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN) as an active registrant.
What field does MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN) work in?
You can think of MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN) as practicing within Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN)?
We surface Greenville, Texas for MRS. SAMANTHA RAE ELMORE (AGACNP-BC, APRN) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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