NPIMap

Individual provider Active NPI

Samuel L Collins, PA-C

  • Physician Assistant
  • Tonasket, WA
National Provider Identifier
1225107089
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
203 S Western Ave
Tonasket, WA 98855-8803
Phone
(509) 486-3144
NPI assigned
Nov 7, 2006
Last updated
Aug 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA60475541 WA
Surgical Physician Assistant 363AS0400X PA9103177 FL
Surgical Physician Assistant 363AS0400X PA00601 OR
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

203 S Western Ave
Tonasket, WA 98855-8803

Mailing address

1510 E Broadway
Mount Vernon, WA 98274-4523
Phone (541) 231-2591

Other practice location 1

3355 Riverbend Dr
Suite 300
Springfield, OR 97477-8800
Phone (541) 868-9323

Other practice location 2

1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone (360) 428-2586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140818002759 WA Practitioner - Physician Assistant 2668370073 Reassigns benefits to 5 organizations
I20230106002072 CA Practitioner - Physician Assistant 2668370073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1800 NW Myhre Rd
Silverdale, WA 98383-7663
Phone (564) 240-1000

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103760NCMDOrthodontics and Dentofacial Orthopedic Dentist
53878CAMDPharmacist
3749WIMDSpeech-Language Pathologist
PA60475541WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Multicare Health System CurrentSince Apr 1, 2021 Accepting new patients
Franciscan Medical Group Physician Assistant CurrentSince Sep 8, 2025 Accepting new patients
Franciscan Medical Group CurrentSince Sep 8, 2025 Accepting new patients
Multicare Health System CurrentSince Apr 1, 2021 Accepting new patients
Okanogan County Public Hospital Dist No 4 CurrentSince Aug 1, 2021 Accepting new patients
Erx Plus Professional Corporation Past Accepting new patients
Centennial Medical Group West, LLC Past Accepting new patients
Centennial Medical Group Inc. Past Accepting new patients
Physician Assistant Services of Florida LLC Surgical Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1617 Main St
Oroville, WA 98844
Phone (509) 476-3631

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

203 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2151

Organizations & group practices 16

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.

View all 16

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1225107089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 E BROADWAY",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744523",
            "telephone_number": "541-231-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S WESTERN AVE",
            "city": "TONASKET",
            "state": "WA",
            "postal_code": "988558803",
            "telephone_number": "509-486-3144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3355 Riverbend Dr",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974778800",
            "country_code": "US",
            "telephone_number": "541-868-9323",
            "fax_number": "541-868-9306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 E Kincaid St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744127",
            "country_code": "US",
            "telephone_number": "360-428-2586",
            "fax_number": "360-428-6470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "SAMUEL",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60475541",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9103177",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA00601",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonasket, WA

Sources for this page

Verify at the official NPI Registry.