Individual provider Active NPI

Samantha Jenkins, O.D.

  • Optometrist
  • Warren, PA
National Provider Identifier
1326296245
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002114 Issued in PA
Practice address
2 Farm Colony Dr
Warren, PA 16365-5206
Phone
(814) 726-2303
Fax
(814) 726-7459
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002114 PA Primary

Addresses

Primary practice location

2 Farm Colony Dr
Warren, PA 16365-5206

Mailing address

2 Farm Colony Dr
Warren, PA 16365-5206
Phone (814) 726-2303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090806000740 PA Practitioner - Optometry 0345392890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Pennsylvania Professional IncGroup PAC ID 7719218593, 80 clinicians

Practice addresses (Care Compare)

187 Scharberry LN
Mars, PA 16046-2429
Phone (724) 591-5501

301 S Hills VLG
Pittsburgh, PA 15241-1400
Phone (412) 854-2222

411 Beaver St
Sewickley, PA 15143-1501
Phone (412) 741-8920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG002114PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Pennsylvania Professional Inc Optometrist CurrentSince Sep 19, 2024 Accepting new patients
Aeg Pennsylvania Professional, Inc Optometrist Past Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

187 Scharberry Ln
Mars, PA 16046
Phone (724) 591-5501

411 Beaver St
Sewickley, PA 15143
Phone (412) 422-5300

Organizations & group practices 2

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": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1326296245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 FARM COLONY DR",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163655206",
            "telephone_number": "814-726-2303",
            "fax_number": "814-726-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FARM COLONY DR",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163655206",
            "telephone_number": "814-726-2303",
            "fax_number": "814-726-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "SAMANTHA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, PA

Sources for this page

Verify at the official NPI Registry.