Samantha McDevitt, PA-C
Individual provider Active NPI Medical Physician Assistant · Mount Laurel, NJ
NPI 1245668672 · NPPES record last updated Oct 3, 2018
Key facts
- NPI
- 1245668672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 25MP00322300 (NJ)
- Practice address
- 4000 Church Rd
Mount Laurel, NJ 08054-1110 - Phone
- (856) 222-4444
- Fax
- (856) 222-0049
- NPI assigned
- Oct 22, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140123000195 | NJ | Practitioner - Physician Assistant | 3375771249 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stroke & Cerebrovascular Center of New Jersey PC | Past | Accepting new patients | |
| Stroke & Cerebrovascular Center of New Jersey | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 25MP00322300 | NJ | Yes |
Addresses
Primary practice location
4000 Church Rd
Mount Laurel, NJ 08054-1110
Mailing address
4000 Church Rd
Mount Laurel, NJ 08054-1110
Phone (856) 222-4444
Other providers in Mount Laurel, NJ
- Louis L McCord
- Erin Lynn McCormick-Kelly
- Stacy A McCrosson
- Kristen McCullen
- Joan McCusker
- Devon McDonald
- Asia McFadden
- John R McGowan
- Claire McGrath
- Lori McGuffin
All providers in Mount Laurel, NJ · Medical Physician Assistant in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.