NPIMap

Individual provider Active NPI

Samantha Whalen Bouthillette, PA-C

  • Surgical Physician Assistant
  • Springfield, MA
National Provider Identifier
1013268218
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA5512 Issued in MA
Practice address
300 Birnie Ave
Springfield, MA 01107-1107
Phone
(413) 785-4666
NPI assigned
Sep 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA5512 MA Primary
Physician Assistant 363A00000X PA5512 MA

Addresses

Primary practice location

300 Birnie Ave
Springfield, MA 01107-1107

Mailing address

75 Russellville Rd
Southampton, MA 01073-9508
Phone (413) 454-2782

Other names 1

  • Ms. Samantha Lynn Whalen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151208000666 MA Practitioner - Physician Assistant 9436300829 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Orthopaedic Alliance PLLCGroup PAC ID 5991149809, 288 clinicians
SC Orthopedics of New England, PC.Group PAC ID 4385907609, 10 clinicians
Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians
Ortho Ma LLCGroup PAC ID 8729515507, 16 clinicians

Practice addresses (Care Compare)

150 Flanders Rd
Westborough, MA 01581-1017
Phone (781) 890-2133

271 Carew St
Springfield, MA 01104-2377
Phone (413) 452-6251

401 Chestnut St
Springfield, MA 01104-3404
Phone (413) 452-6251

53 Southampton Rd
Westfield, MA 01085-1786
Phone (413) 335-2606

975 Springfield St
Feeding Hills, MA 01030-2190
Phone (714) 785-4666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA5512MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ortho Ma LLC Physician Assistant CurrentSince Jan 4, 2026 Accepting new patients
New England Orthopedic Surgeons Physician Assistant CurrentSince Nov 2, 2015 Accepting new patients
Northeast Orthopaedic Alliance PLLC CurrentSince Mar 1, 2024 Accepting new patients
Eastern Connecticut Medical Professionals Foundation Inc Past Accepting new patients

Locations

265 Benton Dr
Ste 101
East Longmeadow, MA 01028
Phone (714) 785-4666

325B King St
Ste 101
Northampton, MA 01060

300 Birnie Ave
Springfield, MA 01107
Phone (413) 736-5649

300 Birnie Ave
Ste 201
Springfield, MA 01107
Phone (413) 233-1292

150 Flanders Rd
Westborough, MA 01581
Phone (508) 870-2222

53 Southampton Rd
Westfield, MA 01085
Phone (413) 335-2606

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHFAED/Endpoint/AHFAED

Organizations & group practices 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1013268218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 RUSSELLVILLE RD",
            "city": "SOUTHAMPTON",
            "state": "MA",
            "postal_code": "010739508",
            "telephone_number": "413-454-2782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BIRNIE AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071107",
            "telephone_number": "413-785-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTHILLETTE",
        "first_name": "SAMANTHA",
        "middle_name": "WHALEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-27",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA5512",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5512",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "WHALEN",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.