Samantha Tavarez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

034272 Issued in NY

Practice address

20 Kellogg Rd
New Hartford, NY 13413-2825

Phone

(315) 765-0903

NPI assigned

Jun 18, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Slocum Dickson Medical Group PLLCGroup PAC ID 5799778510, 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wynn Hospital Hospital, Utica, NY, CCN 330044

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stavarez38036@mvhealthsystem.direct-ci.com

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.

• Slocum Dickson Medical Group PLLC

  • Clinic/Center
  • New Hartford, NY
  • NPI 1285625996
  Medicare reassignment Care Compare group NPD
• High Peaks Medicine PLLC

  • Internal Medicine Physician
  • New Hartford, NY
  • NPI 1679151781
  NPD
• Michael Trociuk, MD PC

  • Anesthesiology Physician
  • New Hartford, NY
  • NPI 1023059888
  NPD (past)

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

• MVHS Inc

  • General Acute Care Hospital
  • Utica, NY
  • NPI 1205877172
  Care Compare affiliation

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

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1003702630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 BURRSTONE RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131001",
            "telephone_number": "315-798-1722",
            "fax_number": "315-798-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 KELLOGG RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134132825",
            "telephone_number": "315-765-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAREZ",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Szempruch
• Megan Marie Tardugno
• Tarris Marriage and Family Therapy LCSW, PLLC
• Britton Adolfo Tarris, LCSW, LMFT
• Deanna Marie Taurisano
• Abbie Taylor
• Caitlyn Taylor, PSY.D.
• Lauren Nicole Taylor, CCC-SLP
• Melanie Taylor, LMSW
• Patricia Ann Taylor, DC

• Physician Assistant in New Hartford, NY
• Providers in New Hartford, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; 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.