Samantha J. Kolock, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1311330 Issued in TX

Practice address

900 W 38TH St Ste 300
Austin, TX 78705-1130

Phone

(512) 450-1300

Fax

(512) 450-1339

NPI assigned

Aug 1, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Fontaine Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Austin Sports Medicine LLPGroup PAC ID 3779596986, 17 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

53.45 of 100Reported as group

Quality

6.89

Improvement activities

40

Cost

68.97

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: samantha.kolock.1@30366.direct.athenahealth.com

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.

• Austin Sports Medicine LLP

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Austin, TX
  • NPI 1770553653
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1285042382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11240 WAPLES MILL RD",
            "address_2": "SUITE 403",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306078",
            "telephone_number": "703-383-6454",
            "fax_number": "703-810-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W 38TH ST STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051130",
            "telephone_number": "512-450-1300",
            "fax_number": "512-450-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLOCK",
        "first_name": "SAMANTHA",
        "middle_name": "J.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-01",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1311330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "FONTAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Morgan Elizabeth Kolencherry, PT, DPT
• Thomas Mark Kolenda, D.C.
• Roshni Lani Koli, M.D.
• Ruth Valarie Kolkman, MD
• Pradyotha Kolli
• Elizabeth Joy Kolodziej, PT, DPT
• Erin Kolpek
• Bharati P Kolte, MD
• Sharon M. Kolton, LPC
• Sydney Maile Kometani, M.D

• Physical Therapist in Austin, TX
• Providers in Austin, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.