Samantha Marie Jacobs, M.S.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT28295 Issued in CA

Practice address

100 Pleasant Hill Ave N
Sebastopol, CA 95472-3104

Phone

(707) 829-3282

Fax

(707) 829-3287

NPI assigned

Feb 13, 2007

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peltz and Associates Physical Therapy IncGroup PAC ID 6002819075, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Peltz and Associates Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Santa Rosa, CA
  • NPI 1356389001

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Sebastopol Physical Therapy and Pilates Studio

  • Physical Therapist
  • Sebastopol, CA
  • NPI 1538201546
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1306988712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PLEASANT HILL AVE N",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723104",
            "telephone_number": "707-829-3282",
            "fax_number": "707-829-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PLEASANT HILL AVE N",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723104",
            "telephone_number": "707-829-3282",
            "fax_number": "707-829-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.S.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ076098",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendell Desmond Jack, D.C
• Ella Jackson, LMFT
• Joy Jaco, LMFT
• Brian Paul Jacobs, LCSW
• Marsha Wolfe Jacobs, MFT
• Jaiyen Spa
• James F Yusuf Q Erskine DO Inc
• Eun Sub Jang, D. D. S.
• Barbara Anne Jason, PHARMACY TECHNICIAN
• Elizabeth Marie Jimenez, LCSW

• Physical Therapist in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.