Individual provider Active NPI

Samantha Siva

  • Physician Assistant
  • White Plains, NY
National Provider Identifier
1356983084
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
40 Primrose St # L2
White Plains, NY 10606-1620
Phone
(218) 464-7871
NPI assigned
Oct 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

40 Primrose St # L2
White Plains, NY 10606-1620

Mailing address

40 Primrose St # L2
White Plains, NY 10606-1620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210308000634 NY Practitioner - Physician Assistant 3678989225 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

400 E Main St
Mount Kisco, NY 10549-3417
Phone (914) 666-1371

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025187NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Dec 14, 2022 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Apr 1, 2021 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Apr 1, 2021 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ssiva69826@northwell.direct-ci.com
  • Direct secure messaging: ssiva@montefioredirect.com

Organizations & group practices 5

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 3

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": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1356983084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PRIMROSE ST # L2",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106061620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 PRIMROSE ST # L2",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106061620",
            "telephone_number": "218-464-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVA",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.