Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shane Samuel

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1558112565

Shane Samuel is a Nurse Practitioner in Mesa, Arizona. Qualified in 2024, 2 years ago. Practices with Peak Mental Health LLC, a 9-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
2
Licensed in
AZ
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Mesa, AZ

No coordinates on file. Search this address in Google Maps

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 308310 (AZ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1558112565
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 28, 2024
Last updated in NPPESJuly 12, 2024
Certification dateJuly 12, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Peak Mental Health Llc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Mesa