Samantha Cecile Hathaway, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2012018757 Issued in MO

Practice address

12632 S Harlem Ave
Palos Heights, IL 60463-1428

Phone

(708) 587-0000

NPI assigned

Jun 24, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL, PA2 enrollments

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 2

Specialty

Internal Medicine

Education

University of Mississippi School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Clair Professional Services IncGroup PAC ID 4284672742, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gallagher Hospice, LLC Hospice, Bridgeville, PA, CCN 391778
• St Clair Hospital Hospital, Pittsburgh, PA, CCN 390228
• Magee Womens Hospital of Upmc Health System Hospital, Pittsburgh, PA, CCN 390114

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shathaway276073@direct.myadvocateaurora.org

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.

• St Clair Professional Services Inc

  • Internal Medicine Physician
  • Pittsburgh, PA
  • NPI 1427270594
  Medicare reassignment Care Compare group NPD
• Dr. Almasri and Associates Inc.

  • Clinic/Center
  • Palos Heights, IL
  • NPI 1104158286
  NPD
• St Clair Professional Services Inc

  • Radiology Clinic/Center
  • Pittsburgh, PA
  • NPI 1366332934
  NPD
• St Clair Memorial Hospital

  • General Acute Care Hospital
  • Pittsburgh, PA
  • NPI 1073587119
  NPD (past)

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

• Gallagher Hospice, LLC

  • Community Based Hospice Care Agency
  • Bridgeville, PA
  • NPI 1891169785
  Care Compare affiliation
• St Clair Memorial Hospital

  • General Acute Care Hospital
  • Pittsburgh, PA
  • NPI 1073587119
  Care Compare affiliation
• Upmc Magee-Womens Hospital

  • Ambulatory Surgical Clinic/Center
  • Pittsburgh, PA
  • NPI 1659435501

  Hospital

  Care Compare affiliation
• Upmc Magee-Womens Hospital

  • General Acute Care Hospital
  • Pittsburgh, PA
  • NPI 1952311508
  Care Compare affiliation

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

{
    "created_epoch": "1340496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1497018477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12632 S HARLEM AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631428",
            "telephone_number": "708-587-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12632 S HARLEM AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631428",
            "telephone_number": "708-587-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "SAMANTHA",
        "middle_name": "CECILE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-24",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2012018757",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2012018757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shathaway276073@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12632 S Harlem Ave",
            "city": "Palos Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604631428",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "12632 S Harlem Ave",
            "city": "Palos Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604631428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Francis Hart Jr., DDS
• Khondakar A Hasanat, MD
• Bassam Hashem, MD
• Tarek I Hassaballa, MD
• Rick L Hastings, L.C.P.C., C.A.D.C.
• Amanda L Hatje, RN, CDCES
• Hauser Chiropractic Care Inc
• Kevin Arthur Hauser, D.C.
• Linda Haworth, OTR/L
• Brittany Hayes, RN, IBCLC

• Internal Medicine Physician in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.