Polly Sams, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00004356 Issued in WA

Practice address

100 E Jackson Ave Ste 301
Ellensburg, WA 98926-3692

Phone

(509) 933-8777

NPI assigned

Oct 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kittitas County Public Hospital Dist 1Group PAC ID 0547179608, 82 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.91 of 100Reported as group

Quality

66.6

Promoting interoperability

100

Improvement activities

40

Cost

69.77

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.

• Kittitas County Public Hospital Dist 1

  • Critical Access Hospital
  • Ellensburg, WA
  • NPI 1356375307
  Medicare reassignment Care Compare group NPD
• Kittitas County Public Hosp Dist 1

  • Urology Physician
  • Ellensburg, WA
  • NPI 1437029832
  NPD
• Kittitas County Public Hospital Dist 1

  • Specialist
  • Ellensburg, WA
  • NPI 1003016825
  NPD
• Kittitas County Public Hospital Dist 1

  • Rural Health Clinic/Center
  • Ellensburg, WA
  • NPI 1770711764
  NPD (past)
• Kittitas County Public Hospital Dist 1

  • Rural Health Clinic/Center
  • Ellensburg, WA
  • NPI 1932115391
  NPD (past)

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1326710997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 S CHESTNUT ST",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263875",
            "telephone_number": "509-962-9841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E JACKSON AVE STE 301",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263692",
            "telephone_number": "509-933-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMS",
        "first_name": "POLLY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00004356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Anne Russell, L.M.P.
• Catherine Rutt
• Susan Rux, L.M.P.
• Safeway Inc
• Jessica Salvati, RN
• John H Sand, M.D.
• Sara Ariana Sandalow, RN
• Itzel Guadalupe Sandoval Manzo, DPT
• Debra Sue Sandvig, RD,CD, IBCLC
• Jillian Santi

• Clinical Social Worker in Ellensburg, WA
• Providers in Ellensburg, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.