Individual provider Active NPI

Samantha Lea McCann, PA-C

  • Medical Physician Assistant
  • Providence, RI
National Provider Identifier
1346698024
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00887 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-5943
NPI assigned
Jun 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00887 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-5943

Other practice location 1

100 Dudley St Fl 3
Providence, RI 02905
Phone (401) 453-3795

Other practice location 2

850 Aquidneck Ave
Middletown, RI 02842-7280
Phone (401) 846-0055

Other identifiers 1

IdentifierTypeStateIssuer
05-0483739OtherRITAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20160822001715 RI Practitioner - Physician Assistant 7113212721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

185 A High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

185 High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

593 Eddy St
Providence, RI 02903-4923

593 Eddy St Apc
Suite 6
Providence, RI 02903-4923
Phone (401) 793-9172

593 Eddy St George BLDG 1St Floor
Providence, RI 02903-4923
Phone (401) 793-9166

Hospital & facility affiliations

  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Sep 13, 2021 Accepting new patients
Lifespan Physician Group, Inc. Medical CurrentSince Sep 13, 2021 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

850 Aquidneck Ave
Middletown, RI 02842
Phone (401) 846-0055

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

593 Eddy St
#2S
Providence, RI 02903
Phone (401) 444-5943

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

593 Eddy St
Providence, RI 02903

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1346698024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Dudley St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "02905",
            "country_code": "US",
            "telephone_number": "401-453-3795",
            "fax_number": "401-453-7748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 Aquidneck Ave",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "RI",
            "postal_code": "028427280",
            "country_code": "US",
            "telephone_number": "401-846-0055",
            "fax_number": "401-842-0963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCANN",
        "first_name": "SAMANTHA",
        "middle_name": "LEA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-02",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "RI",
            "license": "PA00887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "05-0483739",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.