Individual provider Active NPI

Samantha Anderson, PA-S

  • Physician Assistant
  • Melrose, MA
National Provider Identifier
1083444392
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA101994 Issued in MA
Practice address
585 Lebanon St
Melrose, MA 02176-3298
Phone
(781) 979-3000
NPI assigned
Aug 2, 2024
Last updated
Dec 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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 PA101994 MA Primary

Addresses

Primary practice location

585 Lebanon St
Melrose, MA 02176-3298

Mailing address

585 Lebanon St
Melrose, MA 02176-3298
Phone (781) 979-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20260212003279 MA Practitioner - Physician Assistant 1759861479 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hallmark Health Urgent Care Physicians LLCGroup PAC ID 1153557616, 33 clinicians
Melrose Wakefield Emergency Physicians, IncGroup PAC ID 0244143006, 10 clinicians

Practice addresses (Care Compare)

30 New Crossing Rd
Reading, MA 01867-3270
Phone (781) 213-5500

585 Lebanon St
Melrose, MA 02176-3225
Phone (781) 979-3086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA101994MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Urgent Care Physicians LLC Physician Assistant CurrentSince Jan 4, 2026 Accepting new patients
Melrose Wakefield Emergency Physicians, Inc. Physician Assistant CurrentSince Jan 4, 2026 Accepting new patients

Locations

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

30 New Crossing Rd
Reading, MA 01867
Phone (781) 213-5150

Interoperability endpoints

  • Direct secure messaging: sanderson136484@tuftsmedicine.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1083444392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 LEBANON ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763298",
            "telephone_number": "781-979-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 LEBANON ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763298",
            "telephone_number": "781-979-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SAMANTHA",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-02",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA101994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MA

Sources for this page

Verify at the official NPI Registry.