NPIMap

Individual provider Active NPI

Samantha R. Erie, PA-C

  • Physician Assistant
  • Hillsboro, WI
National Provider Identifier
1194164061
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3151-23 Issued in WI
Practice address
400 Water Ave
Hillsboro, WI 54634-9054
Phone
(608) 489-8000
NPI assigned
Jun 24, 2013
Last updated
Feb 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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 3151-23 WI Primary

Addresses

Primary practice location

400 Water Ave
Hillsboro, WI 54634-9054

Mailing address

400 Water Ave
Hillsboro, WI 54634-9054
Phone (608) 489-8000

Other names 1

  • Samantha R Heiking Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130809000461 WI Practitioner - Physician Assistant 4486896032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Health Services IncGroup PAC ID 3971586439, shared by 5 NPIs, 71 clinicians

Practice addresses (Care Compare)

1705 Omaha St
Elroy, WI 53929-9776
Phone (608) 462-8270

301 Railroad Rd
Wonewoc, WI 53968-9425
Phone (608) 464-3575

400 Water Ave
Hillsboro, WI 54634-9054
Phone (608) 489-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3151-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Health Services, Inc. CurrentSince Aug 1, 2013 Accepting new patients
St. Joseph's Health Services, Inc. CurrentSince Aug 1, 2013 Accepting new patients

Locations

125 Main St
Elroy, WI 53929
Phone (608) 462-4116

1705 Omaha St
Elroy, WI 53929
Phone (608) 462-8270

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

301 Railroad Rd
Wonewoc, WI 53968
Phone (608) 464-3111

Interoperability endpoints

  • Direct secure messaging: serie69215@direct.emplifyhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1194164061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WATER AVE",
            "city": "HILLSBORO",
            "state": "WI",
            "postal_code": "546349054",
            "telephone_number": "608-489-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WATER AVE",
            "city": "HILLSBORO",
            "state": "WI",
            "postal_code": "546349054",
            "telephone_number": "608-489-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERIE",
        "first_name": "SAMANTHA",
        "middle_name": "R.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3151-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "HEIKING",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hillsboro, WI

Sources for this page

Verify at the official NPI Registry.