Individual provider Active NPI

Samantha Dayawansa, MD

  • Neurological Surgery Physician
  • Nacogdoches, TX
National Provider Identifier
1376980649
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
V8608 Issued in TX
Practice address
5500 North St
Nacogdoches, TX 75965-1372
Phone
(936) 560-6999
NPI assigned
May 28, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 95099 GA
Neurological Surgery Physician 207T00000X V8608 TX Primary
Neurological Surgery Physician 207T00000X 01096248A IN

Addresses

Primary practice location

5500 North St
Nacogdoches, TX 75965-1372

Mailing address

5500 North St
Nacogdoches, TX 75965-1372
Phone (936) 560-6999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, IN, TX3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230426000910 GA Practitioner - Neurosurgery 5890078950 Reassigns benefits to 1 organization
I20250503000136 IN Practitioner - Neurosurgery 5890078950 Reassigns benefits to 1 organization
I20250914000042 TX Practitioner - Neurosurgery 5890078950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

5500 N St
Nacogdoches, TX 75965-1372
Phone (936) 560-6999

Hospital & facility affiliations

  • Angels Care Home Health Home health agency, Palestine, TX, CCN 458433
  • Nacogdoches Medical Center Hospital, Nacogdoches, TX, CCN 450656
  • VHS Harlingen Hospital Company LLC Hospital, Harlingen, TX, CCN 450033
  • Parkview Whitley Hospital Hospital, Columbia City, IN, CCN 150101
  • Nacogdoches Memorial Hospital Hospital, Nacogdoches, TX, CCN 450508

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
95099GAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Archbold Medical Group, Inc. CurrentSince Jun 1, 2023 Accepting new patients
Archbold Medical Group, Inc. CurrentSince Jun 1, 2023 Accepting new patients
BHS Physicians Network, Inc CurrentSince Aug 21, 2025 Accepting new patients
BHS Physicians Network, Inc CurrentSince Aug 21, 2025 Accepting new patients
Parkview Health System Inc CurrentSince Apr 24, 2025 Accepting new patients
BHS Specialty Network Inc Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102

100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141

704 S Broad St
Thomasville, GA 31792
Phone (229) 226-8880

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

11104 Parkview Circle Dr
Ste 110
Fort Wayne, IN 46845
Phone (260) 425-6780

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020

5500 North St
Nacogdoches, TX 75965
Phone (936) 560-6999

4920 NE Stallings Dr
Nacogdoches, TX 75965
Phone (936) 568-3441

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

Interoperability endpoints

  • Direct secure messaging: sdayawansa676461@direct.parkviewexchange.com
  • Direct secure messaging: samantha.dayawansa.1@1438.direct.athenahealth.com

Organizations & group practices 7

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 6

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": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1376980649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 NORTH ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651372",
            "telephone_number": "936-560-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 NORTH ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651372",
            "telephone_number": "936-560-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAYAWANSA",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-28",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "95099",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "V8608",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IN",
            "license": "01096248A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

Verify at the official NPI Registry.