DR. MARK S I SAMSON (MD) – Psychiatry Physician, NPI 1477569705

DR. MARK S I SAMSON (MD) is a healthcare provider. based in Olympia, Washington. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. MD37632 (WA). The NPI Number for DR. MARK S I SAMSON (MD) is 1477569705

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARK S I SAMSON (MD)
NPI
1477569705
Phone
(360) 923-7000
Address
700 LILLY RD NE
Enumeration Date
31 July 2006
Last Update Date
3 May 2021

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
3603077300
Graduation Year
1997 (29 years ago)
PAC ID
1254408933
Group Practice PAC ID
9032022579
Professional Enrollment ID
I20100219000715
Address ID
WA983839411SI10452NWXX400
Telehealth
Yes

Contacts

SOAP Endpoint
https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

710 PSYCHIATRY in WA

Provider Addresses for DR. MARK S I SAMSON (MD)

  • 700 LILLY RD NE

    OLYMPIA, WA 985065115

    Phone: (360) 923-7000

    Fax: (360) 412-4982

    Type: Mailing

  • 4422, 6th Avenue Southeast, Lacey, Thurston County, Washington, 98503, United States

    LACEY, WA 985031020

    Phone: (360) 704-7170

    Fax: (360) 412-4982

    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: 2010-02-19

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100219000715IPsychiatryWATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98506)

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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: 9032022579View full group profile

Reviews

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Frequently asked questions

Where can patients find DR. MARK S I SAMSON (MD)'s NPI?
You can confirm DR. MARK S I SAMSON (MD) with NPI 1477569705; it appears in the national provider directory.
Does this profile mean DR. MARK S I SAMSON (MD) is currently active?
Yes — DR. MARK S I SAMSON (MD) appears active in the national provider directory.
What does DR. MARK S I SAMSON (MD) treat or focus on?
Patients typically see DR. MARK S I SAMSON (MD) under the specialty Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where is DR. MARK S I SAMSON (MD)'s primary listing?
We display Olympia, Washington because that is what the record indicates for DR. MARK S I SAMSON (MD).
How can I contact DR. MARK S I SAMSON (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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