Individual provider Active NPI

Samantha Nadeau

  • Physician Assistant
  • Brattleboro, VT
National Provider Identifier
1043611627
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
055.0031223 Issued in VT
Practice address
1 Anna Marsh Lane
Brattleboro, VT 05301
Phone
(802) 257-7787
NPI assigned
Sep 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 055.0031223 VT Primary

Addresses

Primary practice location

1 Anna Marsh Lane
Brattleboro, VT 05301

Mailing address

PO Box 803
Anna Marsh Lane
Brattleboro, VT 05301
Phone (802) 257-7787

Other identifiers 1

IdentifierTypeStateIssuer
0474001MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20191216002894 ME Practitioner - Physician Assistant 3072734888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

149 N St
Waterville, ME 04901
Phone (207) 872-1000

15 Enterprise Dr
Mainegeneral Express Care
Augusta, ME 04330-7997
Phone (207) 621-8880

211 Main St
Waterville, ME 04901-6117
Phone (207) 877-3400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
75.39
Promoting interoperability
84
Improvement activities
40
Cost
75.32

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Jan 13, 2020 Accepting new patients
Mainegeneral Medical Center Physician Assistant CurrentSince Jan 13, 2020 Accepting new patients

Locations

15 Enterprise Dr
Augusta, ME 04330
Phone (207) 621-7500

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Interoperability endpoints

  • Direct secure messaging: samanthanadeau@mgh.allscriptsdirect.net

Organizations & group practices 3

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": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1043611627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 803",
            "address_2": "ANNA MARSH LANE",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "05301",
            "telephone_number": "802-257-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ANNA MARSH LANE",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "05301",
            "telephone_number": "802-257-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADEAU",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-15",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0474001",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.