Individual provider

Keariesha Addison Samuels

Primary Care Nurse Practitioner Family Nurse Practitioner Medicare enrolled

Keariesha Addison Samuels is a Primary Care Nurse Practitioner in Sacramento, CA, registered under NPI 1124895958. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.

Getting there

The practice address on file is 77 CADILLAC DR STE 200, Sacramento, CA 95825. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

77 CADILLAC DR STE 200, Sacramento, CA 95825 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
95029249 CA Primary Care Nurse Practitioner primary
11030106 FL Family Nurse Practitioner

Licences are recorded in 2 states: CA, FL. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Nurse Practitioner
PAC ID
2860936630
Enrollment ID
I20240703002605

Medicare enrolment is recorded as approved under the provider type Practitioner - Nurse Practitioner. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: California and Florida. The practice address on file is in Sacramento, CA, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

CA California practice address
Licence
95029249
Specialty
Primary Care Nurse Practitioner
Verify with the CA board →
FL Florida
Licence
11030106
Specialty
Family Nurse Practitioner
Verify with the FL board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Primary Care covers

Definition to come... NUCC Health Care Provider Taxonomy, code 363LP2300X
Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Primary Care

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
363LP2300X Primary Care Nurse Practitioner Primary Care 95029249 CA primary
363LF0000X Family Nurse Practitioner Family 11030106 FL

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1124895958 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateDec 12, 2023
Last updatedAug 12, 2025
StatusActive
Sole proprietorYes
Practice address 77 CADILLAC DR STE 200
Sacramento, CA 95825
(916) 569-8484
Fax (916) 457-2667
Mailing address 3375 SW 173RD WAY
Miramar, FL 33029
This record was updated on Aug 12, 2025, which is recent enough that the contact details are likely still accurate.

Number check

1124895958 passes the NPI check digit test The final digit 8 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 2 4 8 9 5 9 5
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 4 4 7 9 1 9 1

Sum = 62 · next multiple of 10 = 70 · check digit = 8 · actual last digit = 8

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1124895958?
NPI 1124895958 is the National Provider Identifier assigned to Keariesha Addison Samuels in Sacramento, CA. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Primary Care cover?
Definition to come...
How do I contact Keariesha Addison Samuels?
The phone number on file with NPPES is (916) 569-8484, last updated Aug 12, 2025. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Keariesha Addison Samuels accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1124895958 a valid number?
Yes. 1124895958 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.