Samantha Waitzman

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-006222 Issued in IL

Practice address

363 W Erie St Ste 350
Chicago, IL 60654-6933

Phone

(312) 995-1955

NPI assigned

Aug 23, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Rush Medical College of Rush University, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deerfield Dermatology Associates, LTD.Group PAC ID 6204841760, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Merit-based Incentive Payment System (MIPS)

Final score

91.58 of 100Reported as group

Quality

100

Improvement activities

40

Cost

71.92

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

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: swaitzman@directaddress.net
• Direct secure messaging: samantha@deerfieldderm.emadirect.md

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.

• Deerfield Dermatology Associates, LTD.

  • Dermatology Physician
  • Deerfield, IL
  • NPI 1225127244
  Medicare reassignment Care Compare group
• Medical Dermatology Associates of Chicago, LTD

  • Dermatology Physician
  • Chicago, IL
  • NPI 1801285929
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Endeavor Health Clinical Operations

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1457878225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 SPRINGER DR",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486413",
            "telephone_number": "708-634-4602",
            "fax_number": "630-495-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 W ERIE ST STE 350",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606546933",
            "telephone_number": "312-995-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITZMAN",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-006222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "085-006222",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel J Wainwright, MD
• Courtney Waisath, RN
• Lindsey Ann Waite, DPT
• Waiters Chiropractic Wellness Center, LTD
• Lindsey Waitzman, MS, CGC
• Syed Wajid, MD
• Rahila Waka
• Jewel Elizabeth Wakefield, LCSW
• Jordan Wakefield, M.ED., LPC
• Sophia Wakefield

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.