Individual provider Active NPI

Samantha Alexandra Vergano, MD

  • Pediatrics Physician
  • Seattle, WA
National Provider Identifier
1013168673
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
61507346 Issued in WA
Practice address
4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone
(206) 987-2000
NPI assigned
Oct 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 61507346 WA Primary
Clinical Genetics (M.D.) Physician 207SG0201X 0101251368 VA

Addresses

Primary practice location

4800 Sand Point Way NE
Seattle, WA 98105-3901

Mailing address

PO Box 5371
Seattle, WA 98145-5005
Phone (206) 987-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WA2 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

Enrollment IDStateProvider typePAC IDDetails
I20120911000615 VA Practitioner - Pediatric Medicine 5092963397 Reassigns benefits to 1 organization
I20240611002190 WA Practitioner - Pediatric Medicine 5092963397 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61507346WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians CurrentSince Oct 16, 2024 Accepting new patients
Association of CHMC and University Physicians Pediatrics CurrentSince May 29, 2024 Accepting new patients
Childrens Specialty Group PLLC Pediatrics CurrentSince Dec 20, 2015 Accepting new patients
The Association of Chrmc and University Physicians Clinical Genetics (M.D.) CurrentSince May 29, 2024 Accepting new patients

Locations

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

Interoperability endpoints

  • Direct secure messaging: svergano370254@direct.seattlechildrens.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1013168673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5371",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455005",
            "telephone_number": "206-987-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGANO",
        "first_name": "SAMANTHA",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "61507346",
            "primary": true
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "VA",
            "license": "0101251368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.