Individual provider Active NPI

Samantha Mariko Schamp, PA-C

  • Physician Assistant
  • Carson, CA
National Provider Identifier
1245636182
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52052 Issued in CA
Practice address
522 W Carson St
Carson, CA 90745-2635
Phone
(310) 320-3400
Fax
(424) 781-8651
NPI assigned
Nov 4, 2014
Last updated
Oct 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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 52052 CA Primary

Addresses

Primary practice location

522 W Carson St
Carson, CA 90745-2635

Mailing address

522 W Carson St
Carson, CA 90745-2635
Phone (310) 320-3400

Other practice location 1

714 N Avalon Blvd
Wilmington, CA 90744-5809
Phone (310) 522-4200

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
I20151211000641 CA Order and Referring Only - Physician Assistant 0648571919

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
United Urgent Care and Wellness Center, Inc. PastSince Mar 1, 2015 Accepting new patients
Shahram Bonyadlou, MD, Inc. PastSince Dec 5, 2021 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1245636182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 W CARSON ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452635",
            "telephone_number": "310-320-3400",
            "fax_number": "424-781-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 W CARSON ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452635",
            "telephone_number": "310-320-3400",
            "fax_number": "424-781-8651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "714 N Avalon Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "CA",
            "postal_code": "907445809",
            "country_code": "US",
            "telephone_number": "310-522-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHAMP",
        "first_name": "SAMANTHA",
        "middle_name": "MARIKO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-04",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

Verify at the official NPI Registry.