Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Samantha Rose Khundmiri, RN, APNP

Individual provider Family Nurse Practitioner · NPI 1104402361

Samantha Rose Khundmiri, RN, APNP is a Nurse Practitioner in Greendale, Wisconsin. Qualified in 2016, 10 years ago. Practices with Froedtert Andthe Medical College of Wisconsin Community Physicians Inc, a 1,255-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
10
Licensed in
WI
In the registry since
2021
Specialties on file
2
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

6220 W Loomis Rd
Greendale, WI 53129-2448
Phone: (414) 423-0555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 11302-33 (WI)
Registered Nurse Taxonomy 163W00000X · Licence 230241-30 (WI)

Record details

NPI number1104402361
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN , APNP
Sole proprietorNo
NPI enumeratedMarch 19, 2021
Last updated in NPPESSeptember 27, 2021
Certification dateSeptember 27, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Froedtert Andthe Medical College Of Wisconsin Community Physicians Inc — 1255 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients192
Services billed 415 a service is one billed item, such as a visit, a test or a procedure
Average patient age75

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Froedtert Andthe Medical College of Wisconsin Community Physicians Inc

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 1255 clinicians in the practice; 12 are shown here.

Other providers in Greendale