Samantha Kantor Laisure-Pool, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4445 Issued in AZ

Practice address

6320 W Union Hills Dr Ste A100
Glendale, AZ 85308-1099

Phone

(623) 233-1300

Fax

(623) 233-1313

NPI assigned

Oct 14, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Erin Kantor Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Physician Assistant

Education

Midwestern University, Chicago College of Osteopathic Med, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Perinatal Services LLCGroup PAC ID 1658505011, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: samantha.laisure-pool.1@20219.direct.athenahealth.com

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.

• Valley Perinatal Services, LLC

  • Maternal & Fetal Medicine Physician
  • Chandler, AZ
  • NPI 1174866743
  Medicare reassignment Care Compare group
• Fetal and Women'S Center of Arizona, LLC

  • Specialist
  • Scottsdale, AZ
  • NPI 1801822119
  NPD (past)

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1114252863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 W UNION HILLS DR STE A100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081099",
            "telephone_number": "623-233-1300",
            "fax_number": "623-233-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 W UNION HILLS DR STE A100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081099",
            "telephone_number": "623-233-1300",
            "fax_number": "623-233-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAISURE-POOL",
        "first_name": "SAMANTHA",
        "middle_name": "KANTOR",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "KANTOR",
            "middle_name": "ERIN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.