Individual provider Active NPI

Daosamay Sitdamlong, PA-C

  • Physician Assistant
  • North Charleston, SC
National Provider Identifier
1124784608
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2366 Storen St
North Charleston, SC 29406-9039
Phone
(414) 299-8414
NPI assigned
Nov 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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 Primary

Addresses

Primary practice location

2366 Storen St
North Charleston, SC 29406-9039

Mailing address

2366 Storen St
North Charleston, SC 29406-9039
Phone (414) 299-8414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, DC, VA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220513002360 SC Practitioner - Physician Assistant 0143607010 Reassigns benefits to 1 organization
I20241106003429 DC Practitioner - Physician Assistant 0143607010 Reassigns benefits to 1 organization
I20241202000765 VA Practitioner - Physician Assistant 0143607010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Medicine Associates LTDGroup PAC ID 4981688835, 73 clinicians

Practice addresses (Care Compare)

14605 Potomac Branch Dr
Suite 100
Woodbridge, VA 22191-3337
Phone (703) 738-4371

Hospital & facility affiliations

  • Sentara Martha Jefferson Hospital Hospital, Charlottesville, VA, CCN 490077

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine Associates, LTD CurrentSince Nov 1, 2024 Accepting new patients
Physical Medicine Associates, LTD CurrentSince Nov 1, 2024 Accepting new patients
Physical Medicine Associates LTD Past Accepting new patients

Locations

11350 McCormick Rd
Ste 501
Hunt Valley, MD 21031
Phone (410) 329-1071

6355 Walker Ln
Ste 507
Alexandria, VA 22310
Phone (703) 738-4332

1460 Pantops Mountain Pl
Ste 202
Charlottesville, VA 22911
Phone (434) 234-4910

1490 Pantops Mountain Pl
Ste 202
Charlottesvle, VA 22911
Phone (434) 245-6472

5213 Hickory Park Dr
Ste B
Glen Allen, VA 23059
Phone (804) 270-7262

14605 Potomac Branch Dr
Ste 100
Woodbridge, VA 22191
Phone (703) 738-4371

Interoperability endpoints

  • Direct secure messaging: dsitdamlong@spineandpain.emadirect.md

Organizations & group practices 5

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": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1124784608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2366 STOREN ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069039",
            "telephone_number": "414-299-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2366 STOREN ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069039",
            "telephone_number": "414-299-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITDAMLONG",
        "first_name": "DAOSAMAY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.