Individual provider Active NPI

Samantha Rose Witte

  • Surgery Physician
  • Broomall, PA
National Provider Identifier
1457694762
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD464112 Issued in PA
Practice address
1991 Sproul Rd Ste 625
Broomall, PA 19008
Phone
(610) 325-0309
Fax
(610) 325-0459
NPI assigned
Apr 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD464112 PA Primary

Addresses

Primary practice location

1991 Sproul Rd Ste 625
Broomall, PA 19008

Mailing address

3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Phone (484) 337-1601

Other practice location 1

500 University Dr
Hershey, PA 17033
Phone (717) 531-8887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180717000212 PA Practitioner - General Surgery 5890042287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1991 Sproul Rd
Suite 625
Broomall, PA 19008-3524
Phone (610) 642-2002

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physicians Group Surgery CurrentSince Jul 1, 2018 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Jul 1, 2018 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
Main Line Healthcare Surgery CurrentSince Oct 1, 2019 Accepting new patients
Main Line Hospitals, Inc. Past Accepting new patients

Locations

1991 Sproul Rd
Ste 625
Broomall, PA 19008
Phone (484) 421-1669

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

830 Old Lancaster Rd
Ste 300N
Bryn Mawr, PA 19010

830 Old Lancaster Rd
Ste 300
Bryn Mawr, PA 19010
Phone (610) 527-6800

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

120 Valley Green Ln
Ste 660
King of Prussia, PA 19406
Phone (484) 324-7100

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

255 W Lancaster Ave
Ste 332
Paoli, PA 19301
Phone (610) 641-9011

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

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": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1457694762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-337-1601",
            "fax_number": "484-337-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 SPROUL RD STE 625",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "19008",
            "telephone_number": "610-325-0309",
            "fax_number": "610-325-0459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "17033",
            "country_code": "US",
            "telephone_number": "717-531-8887",
            "fax_number": "717-531-4729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITTE",
        "first_name": "SAMANTHA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD464112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

Verify at the official NPI Registry.