Samantha Lee Kyvik

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

025434 Issued in NY

Practice address

147 Ludlam Rd
Monroe, NY 10950-4534

Phone

(917) 715-8978

NPI assigned

May 11, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hudson Dermatology, PCGroup PAC ID 8022021732, 40 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.76 of 100Reported as group

Quality

96.13

Promoting interoperability

100

Improvement activities

40

Cost

79.75

Merit-based Incentive Payment System (MIPS)

Final score

84.72 of 100Reported as individual

Quality

74.95

Promoting interoperability

95

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

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.

• Hudson Dermatology, PC

  • Dermatology Physician
  • Fishkill, NY
  • NPI 1508895384
  Medicare reassignment Care Compare group
• Anderson Medical P.C. Dba Emergency One

  • Urgent Care Clinic/Center
  • Kingston, NY
  • NPI 1114043411
  Medicare reassignment
• BB Medical and Dermatology Inc

  dba BB medical and dermatology

  • MOHS-Micrographic Surgery Physician
  • New York, NY
  • NPI 1790210516
  Medicare reassignment

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598659200000",
    "number": "1184246472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 LUDLAM RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109504534",
            "telephone_number": "917-715-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 LUDLAM RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109504534",
            "telephone_number": "917-715-8978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYVIK",
        "first_name": "SAMANTHA",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearl Kruger, BCBA, LBA
• Angela Kulchytska
• Munish Kumar, DO
• Barbara E Kura, FNP
• Shahjabin Kureshi, PHARMD
• Lab on Wheels LLC
• Elve Laborde, MD
• Caitlin Lakeman
• Lorraine Lamm, CNM
• Laura Ann Laroche, R.N.

• Physician Assistant in Monroe, NY
• Providers in Monroe, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2020; 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.