Individual provider Active NPI

Samantha Lyn Hamilton, NP-BC

  • Nurse Practitioner
  • Wasilla, AK
National Provider Identifier
1053083725
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
219489 Issued in AK
Practice address
3190 E Meridian Park Loop
Wasilla, AK 99654-7422
Phone
(907) 373-9460
NPI assigned
Oct 1, 2021
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 219489 AK Primary
Family Nurse Practitioner 363LF0000X 2021039964 MO

Addresses

Primary practice location

3190 E Meridian Park Loop
Wasilla, AK 99654-7422

Mailing address

1065 Hwy 248
Branson, MO 65616-8398

Other practice location 1

1065 Hwy 248
Branson, MO 65616-8398
Phone (417) 332-3639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20241009003109 AK Practitioner - Nurse Practitioner 3870985617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Medical Group of AlaskaGroup PAC ID 7416243076, 10 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Eagle River, AK 99577-8078
Phone (907) 694-8085

3190 E Meridian Park Loop
Suite 207
Wasilla, AK 99654-7422
Phone (907) 373-9460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
55.96
Improvement activities
40
Cost
79.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Group of Alaska CurrentSince Sep 17, 2024 Accepting new patients
Medical Group of Alaska CurrentSince Sep 17, 2024 Accepting new patients
Medical Group of Alaska Past Accepting new patients

Locations

4361 Boniface Pkwy
Ste 3
Anchorage, AK 99504
Phone (907) 333-2133

3190 E Meridian Park Loop
Ste 207
Wasilla, AK 99654
Phone (907) 357-7710

Interoperability endpoints

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1053083725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 HWY 248",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656168398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 E MERIDIAN PARK LOOP",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547422",
            "telephone_number": "907-373-9460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1065 Hwy 248",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656168398",
            "country_code": "US",
            "telephone_number": "417-332-3639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "SAMANTHA",
        "middle_name": "LYN",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "219489",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021039964",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.