Individual provider Active NPI

Jessica Aurelio Samson, P.A.

  • Medical Physician Assistant
  • Pensacola, FL
National Provider Identifier
1326244146
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9103076 Issued in FL
Practice address
8141 Westbourne Dr
Pensacola, FL 32506-4959
Phone
(954) 478-6371
NPI assigned
Jun 27, 2007
Last updated
Apr 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9103076 FL Primary
Surgical Physician Assistant 363AS0400X PA9103076 FL

Addresses

Primary practice location

8141 Westbourne Dr
Pensacola, FL 32506-4959

Mailing address

8141 Westbourne Dr
Pensacola, FL 32506-4959
Phone (954) 478-6371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20071004000787 FL Practitioner - Physician Assistant 5193810125 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
49.22 of 100Reported as group
Quality
8.06
Improvement activities
40
Cost
90.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9103076FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Urgent Care & Wellness PL CurrentSince Mar 7, 2015 Accepting new patients
Santa Rosa HB Medical Services LLC CurrentSince Sep 23, 2023 Accepting new patients

Locations

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

514 Mary Esther Cut Off NW
Ft Walton Bch, FL 32548
Phone (850) 226-8550

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

4250 Woodbine Rd
Pace, FL 32571
Phone (850) 626-7761

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1326244146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8141 WESTBOURNE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325064959",
            "telephone_number": "954-478-6371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8141 WESTBOURNE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325064959",
            "telephone_number": "954-478-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "JESSICA",
        "middle_name": "AURELIO",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9103076",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9103076",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.