Individual provider Active NPI

Samantha Duffy Noel, PA-C

  • Physician Assistant
  • Encinitas, CA
National Provider Identifier
1285389601
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60754 Issued in CA
Practice address
477 N El Camino Real Ste A306
Encinitas, CA 92024-1350
Phone
(760) 942-0118
NPI assigned
Feb 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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 60754 CA Primary

Addresses

Primary practice location

477 N El Camino Real Ste A306
Encinitas, CA 92024-1350

Mailing address

477 N El Camino Real Ste A306
Encinitas, CA 92024-1350
Phone (760) 942-0118

Other identifiers 1

IdentifierTypeStateIssuer
60754OtherCACALIFORNIA PHYSICIAN ASSISTANT BOARD

Other names 1

  • Ms. Samantha Sachi Takashima Duffy Former name

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
I20240320001306 CA Practitioner - Physician Assistant 9931546462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Coast Family Medical GroupGroup PAC ID 2365491719, 11 clinicians

Practice addresses (Care Compare)

477 N El Camino Real
Encinitas, CA 92024-1350
Phone 76094261181142

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60754CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: samantha.noel.1@9170.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1285389601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL STE A306",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241350",
            "telephone_number": "760-942-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL STE A306",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241350",
            "telephone_number": "760-942-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOEL",
        "first_name": "SAMANTHA",
        "middle_name": "DUFFY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA PHYSICIAN ASSISTANT BOARD",
            "identifier": "60754",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "DUFFY",
            "middle_name": "SACHI TAKASHIMA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.