Individual provider Active NPI

Samantha Lee Hjelmar

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1083393763
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2 Doctors Dr
Greenville, SC 29605-4265
Phone
(864) 797-7320
Fax
(864) 797-7325
NPI assigned
Jul 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

2 Doctors Dr
Greenville, SC 29605-4265

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

823 S Church St Apt 4402
Greenville, SC 29601-4766
Phone (518) 951-8658

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230907004054 SC Practitioner - Physical Therapist in Private Practice 7012371149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenville Proaxis Therapy LLCGroup PAC ID 0244267771, 221 clinicians

Practice addresses (Care Compare)

2 Doctors Dr
Greenville, SC 29605-4265
Phone (864) 797-7320

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Quality
90
Improvement activities
40
Cost
75.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11940SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy LLC CurrentSince Jul 11, 2023 Accepting new patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Jul 11, 2023 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

2 Doctors Dr
Greenville, SC 29605
Phone (864) 558-8955

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

1400 W Georgia Rd
Ste 400
Simpsonville, SC 29680
Phone (864) 757-3053

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": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1083393763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054265",
            "telephone_number": "864-797-7320",
            "fax_number": "864-797-7325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "823 S Church St Apt 4402",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296014766",
            "country_code": "US",
            "telephone_number": "518-951-8658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HJELMAR",
        "first_name": "SAMANTHA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.