Samantha Ashley Stewart, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1154278

Practice address

1165 Montgomery Dr
Santa Rosa, CA 95405-4801

Phone

(949) 381-4966

NPI assigned

Sep 25, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sstewart762697@hisp.ehr.sutterhealth.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Providence Medical Foundation

  • Internal Medicine Physician
  • Santa Rosa, CA
  • NPI 1740584473
  NPD

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1073098000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 NORTHWOOD CT",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945061223",
            "telephone_number": "925-683-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054801",
            "telephone_number": "949-381-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "SAMANTHA",
        "middle_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "1154278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1154278",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Mary Stewart, BSPT
• Gabriel Stewart
• Kim Susan Stewart
• Marlus June Stewart, RAS
• Robert James Stewart, M.D.
• Shelby Ann Stewart, LMFT, APCC
• Jon Stiffler
• Still Life Acupuncture
• Stillwind Psychiatry, a Professional Nursing Corporation
• Ann Stinson, MD

• Physician Assistant in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.