Shaun-Anthony Samson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0593 Issued in NV

Practice address

6370 Goody CT
Las Vegas, NV 89118-1928

Phone

(702) 283-5086

NPI assigned

Jul 21, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Fremont Emergency Services Scherr LTD

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1679550149
  Medicare reassignment
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NV

  Medicare reassignment
• Fremont Emergency Services Scherr LTD

  • Emergency Medicine Physician
  • North Las Vegas, NV
  • NPI 1316488141

  Physician Assistant

  NPD
• Fremont Emergency Services Scherr LTD

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1366429821

  Physician Assistant

  NPD

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1447985569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6370 GOODY CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181928",
            "telephone_number": "702-283-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6370 GOODY CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181928",
            "telephone_number": "702-283-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "SHAUN-ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samsajor LLC
• Samsara Adde LLC
• Grace Marie Samson, APRN
• Raphael Nico Samson
• Ricardo A Samson, M.D.
• Samuel Auerbach MD LTD
• Ivett Samuel Rodriguez
• Carlene Michelle Samuel, M.D.
• Edna Samuel
• Fatima Samuel

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.