Samantha Stack, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

3145 Rosecrans St Ste F
San Diego, CA 92110-4831

Phone

(619) 223-7175

NPI assigned

Aug 9, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Clifton Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rehab United Sports Medicine and Physical Therapy, Inc.Group PAC ID 0446157226, 34 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

74.62 of 100Reported as group

Quality

70

Improvement activities

40

Cost

70.4

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Rehab United Sports Medicine & Physical Therapy, Inc.

  • Physical Therapist
  • San Diego, CA
  • NPI 1134216294
  Medicare reassignment Care Compare group NPD
• Rehab United Sports Medicine & Physical Therapy, Inc.

  • Customized Equipment (DME)
  • Escondido, CA
  • NPI 1891581971
  NPD

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1306529995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 RUFFIN RD STE J",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231830",
            "telephone_number": "858-279-5570",
            "fax_number": "858-279-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 ROSECRANS ST STE F",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104831",
            "telephone_number": "619-223-7175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3959 Ruffin Rd Ste J",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231830",
            "country_code": "US",
            "telephone_number": "858-279-5570",
            "fax_number": "858-279-5303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACK",
        "first_name": "SAMANTHA",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "CLIFTON",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cecylia Teresa Stabrawa, PA-C
• Stac Physical Therapy Pfi, Inc
• Donna Kathleen Stachowicz, DNP, NP-C, CEN
• Shane Stachwick
• Corrie Elizabeth Stack
• Dawn Stackhouse Dickerson, M.ED, IBCLC, RLC, CD
• Stacy Kim Johnston Psychology, Inc.
• Mariah Stacy
• Denise Stading, N.P.
• Kaya R Stadler, M.S., BCBA

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; 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.