Individual provider Active NPI

Samantha Kan, PA-C

  • Medical Physician Assistant
  • Fremont, CA
National Provider Identifier
1205656576
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA65161 Issued in CA
Practice address
3155 Kearney St Ste 100
Fremont, CA 94538-2268
Phone
(510) 931-4310
NPI assigned
Oct 11, 2024
Last updated
Feb 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA65161 CA Primary

Addresses

Primary practice location

3155 Kearney St Ste 100
Fremont, CA 94538-2268

Mailing address

3155 Kearney St Ste 100
Fremont, CA 94538-2268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250219003709 CA Practitioner - Physician Assistant 0446770564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Coast Medicine and Cardiology IncGroup PAC ID 5597035030, 6 clinicians

Practice addresses (Care Compare)

3155 Kearney St
Suite 100
Fremont, CA 94538-2268
Phone (510) 931-4310

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA65161CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of California PC CurrentSince Feb 13, 2025 Accepting new patients

Locations

2690 5th St
Ste B
Alameda, CA 94501
Phone (510) 439-9447

2920 Telegraph Ave
Ste 100
Berkeley, CA 94705
Phone (415) 329-3727

303 Corte Madera Town Ctr
Corte Madera, CA 94925
Phone (415) 840-8615

401 Grand Ave
#1112
Oakland, CA 94610
Phone (800) 756-4206

411 Grand Ave
Oakland, CA 94610
Phone (510) 465-3668

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEBIBD/Endpoint/JEBIBD

Organizations & group practices 2

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 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": "1728604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1205656576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 KEARNEY ST STE 100",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 KEARNEY ST STE 100",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382268",
            "telephone_number": "510-931-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAN",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-11",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA65161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.