Samantha Katherine Pico, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01956700 Issued in NJ

Practice address

4056 Quakerbridge Rd Ste 108
Lawrenceville, NJ 08648-4779

Phone

(201) 801-7141

Fax

(732) 218-5322

NPI assigned

Jan 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Samantha Katherine Stadt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• RB Physical and Occupational Therapy PLLC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1790013282
  NPD (past)
• The Association of University Physicians

  dba University of Washington Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1023041159
  NPD (past)

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1336505734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 RTE 22 FL 2",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072946",
            "telephone_number": "201-801-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4056 QUAKERBRIDGE RD STE 108",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086484779",
            "telephone_number": "201-801-7141",
            "fax_number": "732-218-5322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1455 NW Leary Way",
            "address_2": "#150",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981075124",
            "country_code": "US",
            "telephone_number": "206-782-0218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICO",
        "first_name": "SAMANTHA",
        "middle_name": "KATHERINE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60575553",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01956700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "STADT",
            "middle_name": "KATHERINE",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anita Kamal Persaud, DNP, CPNP
• Angela Marie Petranto, M.A., NCC, LPC
• Joshua Pfeffer, LCSW
• Phoebe Mental Health Care LLC
• Patrycja Ewa Piaseczna
• Melissa Ashley Pieller, MA
• Bruce R Pierce, MD
• Pinnacle Therapy Services P.C.
• Karen E Piren, RN, APN, C
• Andrea E Piscadlo, APN

• Physical Therapist in Lawrenceville, NJ
• Providers in Lawrenceville, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.