MRS. DENISE ANNE SAMPLE (NP-C) – Family Nurse Practitioner, NPI 1083919898
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,268 NURSE PRACTITIONER in WA
Provider Addresses for MRS. DENISE ANNE SAMPLE (NP-C)
216 James St
Seattle, WA 981045102
Phone: (206) 464-1570
Type: Location
834 Sheridan St
Port Townsend, WA 98368
Phone: (360) 385-2200
Type: Location
834 SHERIDAN ST
PORT TOWNSEND, WA 983682443
Phone: (360) 385-2200
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: 2024-11-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 7 Medicare enrollment records; no due dates published yet.
Enrollment records
7
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 |
|---|---|---|---|---|
| I20170615002500 | I | Nurse Practitioner | AZ | TBD |
| I20180326000725 | I | Nurse Practitioner | WA | TBD |
| I20240314004329 | I | Nurse Practitioner | TX | TBD |
| I20240906000155 | I | Nurse Practitioner | GA | TBD |
| I20241030004089 | I | Nurse Practitioner | MI | TBD |
| I20241104003909 | I | Nurse Practitioner | CO | TBD |
| I20241107001084 | I | Nurse Practitioner | KY | 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 98104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | PA | |
| - | AZ | |
| Nurse Practitioner | AZ | |
| Internal Medicine | AZ | |
| Nurse Practitioner | AZ | |
| - | AZ | |
| Family Practice | AZ | |
| Family Practice | NY | |
| Physician Assistant | AZ | |
| Family Practice | AZ |
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