Individual provider Active NPI

Samantha Jo Steelman, PAC

  • Medical Physician Assistant
  • Longmont, CO
National Provider Identifier
1104151570
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2835 Issued in CO
Practice address
1309 Sunset St
Longmont, CO 80501-3215
Phone
(303) 772-5578
Fax
(970) 482-0679
NPI assigned
Oct 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2835 CO Primary

Addresses

Primary practice location

1309 Sunset St
Longmont, CO 80501-3215

Mailing address

670 Arches CT
Berthoud, CO 80513-2684
Phone (970) 381-2803

Other identifiers 3

IdentifierTypeStateIssuer
1104151570OtherCONPI
MS2045208OtherCODEA
2835OtherCOSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20160302001375 CO Practitioner - Physician Assistant 6305142209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Longs Peak Family Practice, PCGroup PAC ID 8527036128, 7 clinicians

Practice addresses (Care Compare)

1309 Sunset St
Longmont, CO 80501-3215
Phone (303) 772-5578

Hospital & facility affiliations

  • Boulder Community Health Hospital, Boulder, CO, CCN 060027
  • Longs Peak Hospital Hospital, Longmont, CO, CCN 060128
  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2835COMDPsychologist

Interoperability endpoints

  • Direct secure messaging: samantha.steelman.p1@direct.rockymtnfamilyphys.nextgenshare.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 and National Provider Directory roles.

Hospital & facility affiliations 50

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

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1104151570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 ARCHES CT",
            "city": "BERTHOUD",
            "state": "CO",
            "postal_code": "805132684",
            "telephone_number": "970-381-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 SUNSET ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013215",
            "telephone_number": "303-772-5578",
            "fax_number": "970-482-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEELMAN",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1104151570",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEA",
            "identifier": "MS2045208",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2835",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.