Ashwath Jonathan Sampath, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036.169691 Issued in IL

Practice address

410 Market St Ste 400
Chapel Hill, NC 27516-4061

Phone

(984) 974-3839

Fax

(984) 974-3692

NPI assigned

Apr 26, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Dermatology

Education

University of Missouri, Columbia School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Health PhysiciansGroup PAC ID 1153235825, 344 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Truman Medical Center Hospital Hill Hospital, Kansas City, MO, CCN 260048

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asampath@directaddress.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University Health Physicians

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1669456257
  Medicare reassignment Care Compare group NPD
• Dermatology and Mohs Surgery Institute, LTD.

  • Specialist
  • Bloomington, IL
  • NPI 1770828626
  Medicare reassignment NPD
• Soderstrom Dermatology Center S C

  • Dermatology Physician
  • Peoria, IL
  • NPI 1710931670
  Medicare reassignment NPD
• Soderstrom Dermatology Center S C

  • Ambulatory Surgical Clinic/Center
  • Peoria, IL
  • NPI 1053362343
  NPD
• University of North Carolina at Chapel Hill

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200

  Dermatology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Truman Medical Center, Incorporated

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1467595793
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1003470832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MARKET ST STE 400",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275164061",
            "telephone_number": "984-974-3839",
            "fax_number": "984-974-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MARKET ST STE 400",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275164061",
            "telephone_number": "984-974-3839",
            "fax_number": "984-974-3692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3660 Vista Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631102540",
            "country_code": "US",
            "telephone_number": "314-977-6100",
            "fax_number": "314-977-6164",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14343 White Birch Valley Ln",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630172413",
            "country_code": "US",
            "telephone_number": "314-809-7028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPATH",
        "first_name": "ASHWATH",
        "middle_name": "JONATHAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-26",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.169691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dino Jubal Salvanera, DMD
• Susan Phyllis Salzberg, OTR/L
• Lisa Carol Samanas, PHARMD
• Sonja Samant, MD
• Ahmad Salah Sami, MD
• Amani Sampson
• Lattice Sams
• Allen Douglas Samuelson, DDS
• David Barrow Samuelson, D.D.S.
• Tamara Campbell Samuelson, D.M.D

• Dermatology Physician in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.