Samantha De Groot, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Sioux Falls, SD
NPI 1346092541 · NPPES record last updated Apr 2, 2024
Key facts
- NPI
- 1346092541
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 1400 W 22ND St
Sioux Falls, SD 57105-1554 - Phone
- (605) 312-8489
- NPI assigned
- Apr 2, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240627002312 | SD | Order and Referring Only - Neurology |
1557805868 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810 | SD | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
1400 W 22ND St
Sioux Falls, SD 57105-1554
Mailing address
40 Brookside CT
Copiague, NY 11726-3904
Phone (507) 321-3233
Other providers in Sioux Falls, SD
- DBM, LLC
- Christopher De Berg
- Kristen Leann De Berg
- Rachel Lyn De Boer
- Karen De Bruin
- Paige Nicole De Haan
- De Jong Behavioral Health Services, PLLC
- Mitzi Quetzal De la Cruz-Garcia
- Carla Valentina De Matos Konrad
- Debora De Oliveira Dutra Vidal Barbosa
All providers in Sioux Falls, SD · Student in an Organized Health Care Education/Training Program in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.