Individual provider Active NPI

Olga Samplawski, MMSC, PA-C

  • Medical Physician Assistant
  • Redding, CA
National Provider Identifier
1093055303
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
59732 Issued in CA
Practice address
1742 Oregon St
Redding, CA 96001-1717
Phone
(530) 646-7269
NPI assigned
Feb 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-03880 NC
Medical Physician Assistant 363AM0700X 59732 CA Primary

Addresses

Primary practice location

1742 Oregon St
Redding, CA 96001-1717

Mailing address

2165 Larkspur LN
Redding, CA 96002-0600
Phone (530) 226-7419

Other practice location 1

5815 Blakeney Park Dr
Suite 200
Charlotte, NC 28277-5731
Phone (704) 316-5080

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230622001424 CA Practitioner - Physician Assistant 3072756691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Native American Mental Health Services CorporationGroup PAC ID 5395072490, 62 clinicians

Practice addresses (Care Compare)

1035 Cass St
Monterey, CA 93940-4517
Phone (831) 886-0030

1742 Oregon St
Redding, CA 96001-1717
Phone (530) 646-7269

420 S Main St
Red Bluff, CA 96080-4316
Phone (888) 297-8080

450 Lincoln Ave
Suite 101
Salinas, CA 93901-2652
Phone (831) 269-5988

500 Chadbourne Rd
Suite B
Fairfield, CA 94534-9644
Phone (707) 439-4039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59732CAMDPharmacist

Organizations & group practices 1

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": "1361491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1093055303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 LARKSPUR LN",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020600",
            "telephone_number": "530-226-7419",
            "fax_number": "530-262-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 OREGON ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011717",
            "telephone_number": "530-646-7269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5815 Blakeney Park Dr",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282775731",
            "country_code": "US",
            "telephone_number": "704-316-5080",
            "fax_number": "704-316-5085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPLAWSKI",
        "first_name": "OLGA",
        "credential": "MMSC, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-22",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-03880",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "59732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.