Individual provider Active NPI

Samurdhi Jayaweera Roberts, PA-C

  • Physician Assistant
  • Summerville, SC
National Provider Identifier
1467774042
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3822 Issued in SC
Practice address
501 Carnes Crossing Blvd Ste B
Summerville, SC 29486-0407
Phone
(843) 212-8080
Fax
(843) 203-2299
NPI assigned
Feb 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3822 SC Primary

Addresses

Primary practice location

501 Carnes Crossing Blvd Ste B
Summerville, SC 29486-0407

Mailing address

PO Box 632516
Cincinnati, OH 45263-2516
Phone (888) 472-0043

Other identifiers 1

IdentifierTypeStateIssuer
4854PAMedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Samurdhi.Roberts@rsfpp.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20211217001721 SC Practitioner - Physician Assistant 3173801560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1114 N Main St
Summerville, SC 29483-7326
Phone (843) 212-8070

1711 Clements Ferry Rd
Unit 112
Charleston, SC 29492-8717
Phone (843) 606-7893

2075 Eagle Landing Blvd
N Charleston, SC 29406-4074
Phone (843) 789-1800

319 Folly Rd
Charleston, SC 29412-2518
Phone (843) 723-8823

3885 W Ashley Cir
Suite F600
Charleston, SC 29414-9273
Phone (843) 853-3474

4278 Ladson Rd
Ladson, SC 29456-5452
Phone (844) 975-6683

8901 University Blvd
N Charleston, SC 29406-9116
Phone (843) 789-1850

Hospital & facility affiliations

  • Roper Hospital Hospital, Charleston, SC, CCN 420087

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3822SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince Jan 31, 2022 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jan 31, 2022 Accepting new patients
Roper Saint Francis Physicians Network Past Accepting new patients

Locations

3885 W Ashley Cir
Ste F600
Charleston, SC 29414
Phone (843) 402-1360

3575 Maybank Hwy
Ste A
Johns Island, SC 29455
Phone (843) 402-1870

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

5070 International Blvd
Ste 131
North Charleston, SC 29418
Phone (843) 402-2995

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

501 Carnes Crossing Blvd
#B
Summerville, SC 29486
Phone (843) 212-8080

Interoperability endpoints

  • Direct secure messaging: sroberts1236061@direct.bsmhealth.org
  • Direct secure messaging: samurdhi.roberts@rsfpp.eclinicaldirectplus.com

Organizations & group practices 4

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 1

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": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1467774042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632516",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632516",
            "telephone_number": "888-472-0043",
            "fax_number": "513-653-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 CARNES CROSSING BLVD STE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294860407",
            "telephone_number": "843-212-8080",
            "fax_number": "843-203-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SAMURDHI",
        "middle_name": "JAYAWEERA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-23",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4854PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Samurdhi.Roberts@rsfpp.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Document and CCD Exchange",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Patient Care Documents",
            "address_1": "5070 International Blvd Ste 131",
            "city": "N Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294186007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.