Samantha K Ezolt, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

13 Western Maryland Pkwy Ste 104
Hagerstown, MD 21740-6474

Phone

(301) 665-4575

Fax

(301) 665-4576

NPI assigned

Aug 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Samantha K Engle Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-State Orthopaedics and Sports Medicine, Inc.Group PAC ID 2365342284, 59 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Passavant Hospital, Pittsburgh, PA, CCN 390107

Merit-based Incentive Payment System (MIPS)

Final score

93.13 of 100Reported as group

Quality

87.5

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: 04sengle@cfaortho.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tri-State Orthopaedics & Sports Medicine, Inc.

  • Orthopaedic Surgery Physician
  • Pittsburgh, PA
  • NPI 1174568232
  Medicare reassignment Care Compare group NPD
• Kids Plus Pediatrics

  • Pediatrics Physician
  • Pittsburgh, PA
  • NPI 1942526314
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Upmc Passavant

  • General Acute Care Hospital
  • Pittsburgh, PA
  • NPI 1225047699
  Care Compare affiliation
• Upmc Passavant

  • Ambulatory Surgical Clinic/Center
  • Pittsburgh, PA
  • NPI 1639218936

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1245885482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 WESTERN MARYLAND PKWY STE 104",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406474",
            "telephone_number": "301-665-4575",
            "fax_number": "301-665-4576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 WESTERN MARYLAND PKWY STE 104",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406474",
            "telephone_number": "301-665-4575",
            "fax_number": "301-665-4576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZOLT",
        "first_name": "SAMANTHA",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "ENGLE",
            "middle_name": "K",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffrey J Ewart
• Eyecare Professionals P C
• Audrey Eyler
• Juris G. Eyler, PA-S
• Michelle Denise Eyler, ANP-BC
• Leora Ezri
• Marlene Elizabeth Facine
• Fahrney-Keedy Memorial Home, Inc
• Fahrney-Keedy Memorial Home, Inc
• Lauren Nicole Fahrney, PMHNP-BC

• Medical Physician Assistant in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.