Individual provider Active NPI

Samantha N Sokol, PAC

  • Physician Assistant
  • Gig Harbor, WA
National Provider Identifier
1104354190
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60763659 Issued in WA
Practice address
11511 Canterwood Blvd Ste 100
Gig Harbor, WA 98332-5813
Phone
(253) 382-8150
Fax
(253) 382-8155
NPI assigned
Jun 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA60763659 WA
Physician Assistant 363A00000X PA60763659 WA Primary

Addresses

Primary practice location

11511 Canterwood Blvd Ste 100
Gig Harbor, WA 98332-5813

Mailing address

11511 Canterwood Blvd Ste 100
Gig Harbor, WA 98332-5813
Phone (253) 382-8150

Other identifiers 1

IdentifierTypeStateIssuer
2086628MedicaidWA

Other names 1

  • Samantha N Hull Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssokol240788@fhsce.catholichealth.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20170914003413 WA Practitioner - Physician Assistant 5294009254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

11511 Canterwood Blvd
Gig Harbor, WA 98332-5813

11511 Canterwood Blvd NW
Suite 100
Gig Harbor, WA 98332-5813
Phone (253) 627-1244

11567 Canterwood Blvd NW
Gig Harbor, WA 98332-5812
Phone (253) 426-6341

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

Hospital & facility affiliations

  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince May 7, 2018 Accepting new patients
Franciscan Medical Group CurrentSince May 7, 2018 Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients

Locations

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

11511 Canterwood Blvd
Ste 100
Gig Harbor, WA 98332
Phone (253) 382-8150

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 4

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1104354190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD STE 100",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325813",
            "telephone_number": "253-382-8150",
            "fax_number": "253-382-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD STE 100",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325813",
            "telephone_number": "253-382-8150",
            "fax_number": "253-382-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOKOL",
        "first_name": "SAMANTHA",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-02",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60763659",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60763659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2086628",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssokol240788@fhsce.catholichealth.net",
            "affiliation": "N",
            "address_1": "1717 S J St",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "HULL",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gig Harbor, WA

Sources for this page

Verify at the official NPI Registry.