Individual provider Active NPI

Samantha Lynn Moran, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1417597766
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18107 Issued in TX
Practice address
5251 W Highway 290
Austin, TX 78735-8963
Phone
(512) 654-3000
NPI assigned
Jan 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X C0007397 MD
Physician Assistant 363A00000X PA18107 TX Primary

Addresses

Primary practice location

5251 W Highway 290
Austin, TX 78735-8963

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (800) 994-0371

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smoran1321438@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200219002449 MD Practitioner - Physician Assistant 5193152866 Reassigns benefits to 2 organizations
I20240718000911 TX Practitioner - Physician Assistant 5193152866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

100 Medical Pkwy
Lakeway, TX 78738-5621
Phone (512) 571-5000

11209 S Interstate Hwy 35
Baylor Scott and White Clinic Onion
Austin, TX 78747-1712
Phone (512) 654-4700

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

1701 E Pflugerville Pkwy
Baylor Scott and White Clinic Pflug
Pflugerville, TX 78660-8990
Phone (512) 259-6000

200 Medical Pkwy
Lakeway, TX 78738-1794

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

2608 Brockton Dr
Austin, TX 78758-4414
Phone (512) 654-4050

3108 Ranch Rd 620
Lakeway, TX 78738-5635
Phone (512) 654-4200

5000 W Slaughter LN 100 BLDG
6 Baylor Scott and White Clinic Austi
Austin, TX 78749-4015
Phone (512) 291-8002

5245 W Hwy 290
Baylor Scott and White Medical Center Austi
Austin, TX 78735-8963
Phone (512) 654-2100

5251 W Hwy 290
Baylor Scott and White Clinic Austin Oak Hi
Austin, TX 78735-8963
Phone (512) 654-3000

5251 W Hwy 290 100
Baylor Scott and White Cancer and Infusion Ce
Austin, TX 78735-8963
Phone (512) 654-4319

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0007397MDMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Feb 1, 2020 Accepting new patients
Johns Hopkins University CurrentSince Feb 1, 2020 Accepting new patients
Johns Hopkins University CurrentSince Feb 1, 2020 Accepting new patients
Scott & White Clinic CurrentSince Jun 7, 2024 Accepting new patients
Johns Hopkins University CurrentSince Feb 1, 2020 Accepting new patients
Scott and White Clinic CurrentSince Jun 7, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

600 N Wolfe St
Baltimore, MD 21287

4940 Eastern Ave
Baltimore, MD 21224

9910 Franklin Square Dr
Ste 2110
Nottingham, MD 21236
Phone (410) 933-5412

5245 W Highway 290
Austin, TX 78735
Phone (512) 509-0100

5251 W Highway 290
Austin, TX 78735
Phone (512) 654-3000

5330 Overpass Rd
Ste 110
Buda, TX 78610
Phone (737) 999-6200

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

200 Medical Pkwy
Ste 130
Lakeway, TX 78738
Phone (512) 654-2300

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

1701 E Pflugerville Pkwy
Pflugerville, TX 78660
Phone (512) 259-6000

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: smoran1321438@direct.sw.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1417597766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "800-994-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5251 W HIGHWAY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358963",
            "telephone_number": "512-654-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0007397",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smoran1321438@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5251 W Highway 290",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787358963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.