Individual provider Active NPI

Samantha Dhoman, PA-C

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1376935205
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
018387-1 Issued in NY
Practice address
1250 Waters Place
#1206
Bronx, NY 10461
Phone
(718) 409-5454
NPI assigned
Mar 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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 018387-1 NY Primary

Addresses

Primary practice location

1250 Waters Place
#1206
Bronx, NY 10461

Mailing address

1250 Waters Place
#1206
Bronx, NY 10461
Phone (718) 409-5454

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
I20190122001396 NY Practitioner - Physician Assistant 4183961766 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
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)

222 E Middle Country Rd
Smithtown, NY 11787-2871
Phone (631) 968-8268

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

734 Park Ave
Huntington, NY 11743-3900
Phone (631) 271-1640

752 Park Ave
Huntington, NY 11743-3900
Phone (631) 470-8940

Hospital & facility affiliations

  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

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
018387NYMDOccupational Therapist
018387-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence Medical Associates, PC CurrentSince Jan 1, 2019 Accepting new patients
Lawrence Medical Associates, PC CurrentSince Jan 1, 2019 Accepting new patients
North Shore - Lij Medical PC CurrentSince Dec 21, 2022 Accepting new patients

Locations

1250 Waters Pl
Ste 1206
Bronx, NY 10461
Phone (718) 409-5454

685 White Plains Rd
Lowr
Eastchester, NY 10709
Phone (914) 787-4100

685 White Plains Rd
Fl 2
Eastchester, NY 10709
Phone (914) 787-4100

752 Park Ave
Huntington, NY 11743
Phone (631) 271-9017

300 Community Dr
Plandome, NY 11030

222 E Middle Country Rd
Ste 114
Smithtown, NY 11787
Phone (631) 292-6748

222 E Middle Country Rd
Ste 210
Smithtown, NY 11787
Phone (631) 265-6868

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Organizations & group practices 4

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 1

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": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1376935205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 WATERS PLACE",
            "address_2": "#1206",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "718-409-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 WATERS PLACE",
            "address_2": "#1206",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "718-409-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHOMAN",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018387-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.